Individual
NATHAN DIAZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, RD, LDN
Contact information
Practice address
654 BEACON ST, BOSTON, MA 02215-2099
(617) 536-1161
Mailing address
30 CALDWELL ST UNIT 135, CHARLESTOWN, MA 02129-1217
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
4284
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4284
REGISTERED DIETITIAN STATE LICENSE
MA
01
—
86067011
COMMISSION ON DIETETIC REGISTRATION
—
Enumeration date
07/27/2017
Last updated
03/17/2018
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