Provider Demographics
NPI:1427868108
Name:BOYLE, MAUREEN A (MBA, RD)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:A
Last Name:BOYLE
Suffix:
Gender:F
Credentials:MBA, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63A PINE ST
Mailing Address - Street 2:
Mailing Address - City:WOBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01801-3225
Mailing Address - Country:US
Mailing Address - Phone:617-957-7687
Mailing Address - Fax:781-491-0708
Practice Address - Street 1:63A PINE ST
Practice Address - Street 2:
Practice Address - City:WOBURN
Practice Address - State:MA
Practice Address - Zip Code:01801-3225
Practice Address - Country:US
Practice Address - Phone:617-957-7687
Practice Address - Fax:781-491-0708
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-13
Last Update Date:2025-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALDN2552133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered