Provider Demographics
NPI:1306246574
Name:MEG SALVIA NUTRITION, LLC
Entity type:Organization
Organization Name:MEG SALVIA NUTRITION, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:
Authorized Official - Last Name:SALVIA
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:651-402-6256
Mailing Address - Street 1:26 TUFTS ST
Mailing Address - Street 2:#1
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02139-4720
Mailing Address - Country:US
Mailing Address - Phone:651-402-6256
Mailing Address - Fax:
Practice Address - Street 1:1280 MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-3840
Practice Address - Country:US
Practice Address - Phone:617-782-3933
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-25
Last Update Date:2014-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3589133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty