Provider Demographics
NPI:1962526186
Name:CELESIA, TIANA (RD)
Entity type:Individual
Prefix:
First Name:TIANA
Middle Name:
Last Name:CELESIA
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:120 PURITAN RD
Mailing Address - Street 2:
Mailing Address - City:SWAMPSCOTT
Mailing Address - State:MA
Mailing Address - Zip Code:01907-2716
Mailing Address - Country:US
Mailing Address - Phone:617-905-2219
Mailing Address - Fax:
Practice Address - Street 1:102 CHARLES ST
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-4607
Practice Address - Country:US
Practice Address - Phone:617-720-1992
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered