Organization
SUDBURY RACQUET CLUB INC.
Active
Other names
The Longfellow Club
Organization subpart
No
Provider details
NPI number
Authorized official
MISS JANE POLLEY M.S., R.D., LDN (DIETITIAN)
(508) 358-7355
Entity
Organization
Contact information
Practice address
524 BOSTON POST RD, THE LONGFELLOW CLUB, WAYLAND, MA 01778-1833
(508) 358-7355
(508) 358-3525
Mailing address
524 BOSTON POST RD, THE LONGFELLOW CLUB, WAYLAND, MA 01778-1833
(508) 358-7355
(508) 358-3525
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
39411
HARVARD PILGRIM HEALTH
MA
01
—
5582051
AETNA
MA
01
—
6300209
UNITED HEALTH CARE
MA
01
—
763282
TUFTS
MA
01
—
LG0023
BLUE CROSS BLUE SHIELD
MA
Enumeration date
11/24/2006
Last updated
06/09/2015
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