Provider Demographics
NPI:1700121969
Name:SEITZ, CRISTINE (MS RD LDN)
Entity type:Individual
Prefix:
First Name:CRISTINE
Middle Name:
Last Name:SEITZ
Suffix:
Gender:F
Credentials:MS RD LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 STATION ST STE 100
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02445-7995
Mailing Address - Country:US
Mailing Address - Phone:774-315-3056
Mailing Address - Fax:857-216-8558
Practice Address - Street 1:17 STATION ST STE 100
Practice Address - Street 2:
Practice Address - City:BROOKLINE
Practice Address - State:MA
Practice Address - Zip Code:02445-7995
Practice Address - Country:US
Practice Address - Phone:774-315-3056
Practice Address - Fax:857-216-8558
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-29
Last Update Date:2024-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3399133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered