Individual
MRS. PAMELA D BERMUDEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD,LDN,CDE
Contact information
Practice address
3 LEEWARD LN, DARTMOUTH, MA 02748-3726
(774) 526-1586
(508) 996-4783
Mailing address
3 LEEWARD LN, DARTMOUTH, MA 02748-3726
(774) 526-1586
(508) 996-4783
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
NU 1386
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00412700
HMO BCBS OF RI
RI
01
—
11463774
CAQH PROVIDER ID
—
01
—
1816971
CIGNA
—
01
—
29678-2
BCBS OF RI
RI
01
—
468058
TUFTS HEALTH PLAN
—
01
—
655598
REGISTER DIETITIAN
—
01
—
AA27307
HPHC
—
01
—
LD0164
BCBS MA
—
01
—
NU 1386
STATE LICENSE
MA
Enumeration date
07/26/2006
Last updated
07/09/2007
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