Provider Demographics
NPI:1386829349
Name:MCDONAGH, MAUREEN ANN (RD)
Entity type:Individual
Prefix:MS
First Name:MAUREEN
Middle Name:ANN
Last Name:MCDONAGH
Suffix:
Gender:F
Credentials:RD
Other - Prefix:MS
Other - First Name:MAUREEN
Other - Middle Name:ANN
Other - Last Name:ROZES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:320 THAMES ST.
Mailing Address - Street 2:#445
Mailing Address - City:NEWPORT
Mailing Address - State:RI
Mailing Address - Zip Code:02840
Mailing Address - Country:US
Mailing Address - Phone:401-855-5885
Mailing Address - Fax:
Practice Address - Street 1:179 BEACH ST.
Practice Address - Street 2:
Practice Address - City:NORTH KINGSTOWN
Practice Address - State:RI
Practice Address - Zip Code:02852
Practice Address - Country:US
Practice Address - Phone:401-855-5885
Practice Address - Fax:401-781-3375
Is Sole Proprietor?:No
Enumeration Date:2008-01-08
Last Update Date:2019-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RILDN00611133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered