Provider Demographics
NPI:1528174232
Name:PATALANO, KAREN KIVER (MBA, RD, LDN)
Entity type:Individual
Prefix:MS
First Name:KAREN
Middle Name:KIVER
Last Name:PATALANO
Suffix:
Gender:F
Credentials:MBA, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:567 CENTRAL ST
Mailing Address - Street 2:
Mailing Address - City:BOYLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:01505-1523
Mailing Address - Country:US
Mailing Address - Phone:508-869-2824
Mailing Address - Fax:508-869-2814
Practice Address - Street 1:567 CENTRAL ST
Practice Address - Street 2:
Practice Address - City:BOYLSTON
Practice Address - State:MA
Practice Address - Zip Code:01505-1523
Practice Address - Country:US
Practice Address - Phone:508-869-2824
Practice Address - Fax:508-869-2814
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1079133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAAA32701OtherHARVARD PILGRIM
MALD0149OtherBLUE CROSS BLUE SHIELD
MA470424OtherTUFTS HEALTH CARE
MA470424OtherTUFTS HEALTH CARE