Provider Demographics
NPI:1609199702
Name:FRANKEL, FARRELL MAIA
Entity type:Individual
Prefix:
First Name:FARRELL
Middle Name:MAIA
Last Name:FRANKEL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 WILLOW TER
Mailing Address - Street 2:
Mailing Address - City:NEWTON CENTRE
Mailing Address - State:MA
Mailing Address - Zip Code:02459-1805
Mailing Address - Country:US
Mailing Address - Phone:917-685-9494
Mailing Address - Fax:
Practice Address - Street 1:1 WILLOW TER
Practice Address - Street 2:
Practice Address - City:NEWTON CENTRE
Practice Address - State:MA
Practice Address - Zip Code:02459-1805
Practice Address - Country:US
Practice Address - Phone:917-685-9494
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-04
Last Update Date:2025-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALDN6602133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered