Provider Demographics
NPI:1942188099
Name:BISHOP, ROWAN (RDN, LDN)
Entity type:Individual
Prefix:
First Name:ROWAN
Middle Name:
Last Name:BISHOP
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 MYSTIC ST APT 3
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02474-1142
Mailing Address - Country:US
Mailing Address - Phone:413-801-2629
Mailing Address - Fax:
Practice Address - Street 1:66 MYSTIC ST APT 3
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02474-1142
Practice Address - Country:US
Practice Address - Phone:413-801-2629
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-26
Last Update Date:2025-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALDN8394133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered