Provider Demographics
NPI:1538922620
Name:ZIOMEK, MAKAYLA (RD)
Entity type:Individual
Prefix:
First Name:MAKAYLA
Middle Name:
Last Name:ZIOMEK
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 1:143 NORTH ST
Mailing Address - Street 2:
Mailing Address - City:ERVING
Mailing Address - State:MA
Mailing Address - Zip Code:01344-9734
Mailing Address - Country:US
Mailing Address - Phone:413-239-4232
Mailing Address - Fax:
Practice Address - Street 1:1 RIVER ST STE 104
Practice Address - Street 2:
Practice Address - City:ERVING
Practice Address - State:MA
Practice Address - Zip Code:01344-4403
Practice Address - Country:US
Practice Address - Phone:413-239-4232
Practice Address - Fax:413-707-6397
Is Sole Proprietor?:No
Enumeration Date:2024-02-01
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALDN4658133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered