Provider Demographics
NPI:1306114749
Name:BROWN, DARCY (RD, LDN)
Entity type:Individual
Prefix:
First Name:DARCY
Middle Name:
Last Name:BROWN
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 LONGWOOD AVE
Mailing Address - Street 2:4TH FLOOR, CENTER FOR NUTRITION
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02115-5711
Mailing Address - Country:US
Mailing Address - Phone:617-355-4677
Mailing Address - Fax:617-730-4722
Practice Address - Street 1:333 LONGWOOD AVE
Practice Address - Street 2:4TH FLOOR, CENTER FOR NUTRITION
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02115-5711
Practice Address - Country:US
Practice Address - Phone:617-355-4677
Practice Address - Fax:617-730-4722
Is Sole Proprietor?:No
Enumeration Date:2011-12-13
Last Update Date:2014-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3601133V00000X
RILDN00703133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3601OtherLICENSE NUMBER
RILDN00703OtherLICENSE NUMBER