| Amanda Lauren Matos, | |
|
450 Veterans Memorial Pkwy Ste 8c, East Providence, RI 02914-5300 | |
| (401) 396-9331 | |
| Not Available |
| Full Name | Amanda Lauren Matos |
|---|---|
| Gender | Female |
| Speciality | Dietitian, Registered |
| Location | 450 Veterans Memorial Pkwy Ste 8c, East Providence, Rhode Island |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932823739 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | (* (Not Available)) | Primary |
| Provider Name | Evolution Nutrition Inc |
|---|---|
| Provider Type | Part B Supplier - Clinic/group Practice |
| Provider Identifiers | NPI Number: 1336265800 PECOS PAC ID: 2163668518 Enrollment ID: O20130410000052 |
| Mailing Address | Practice Location Address |
|---|---|
| Amanda Lauren Matos, 13 Jillian Way, Westport, MA 02790-4231 Ph: (774) 319-1074 | Amanda Lauren Matos, 450 Veterans Memorial Pkwy Ste 8c, East Providence, RI 02914-5300 Ph: (401) 396-9331 |
Mrs. Emily Snow Delconte, RD Dietitian Medicare: Accepting Medicare Assignments Practice Location: 450 Veterans Memorial Pkwy Ste 8c, East Providence, RI 02914 Phone: 401-396-9331 Fax: 401-396-9369 | |
Sarah Dorothy Mosley, RD, LDN Dietitian Medicare: Accepting Medicare Assignments Practice Location: 450 Veterans Memorial Pkwy, 8c, East Providence, RI 02914 Phone: 401-396-9331 Fax: 401-396-9369 | |
Ms. Colby Thibault, RD, LDN Dietitian Medicare: Not Enrolled in Medicare Practice Location: 36 Captain John Jacobs Rd Apt 209, East Providence, RI 02914 Phone: 774-319-1606 | |
Nutrition, Inc. Dietitian Medicare: Medicare Enrolled Practice Location: 525 Taunton Ave, East Providence, RI 02914 Phone: 401-490-0900 Fax: 401-490-0975 | |
Miss Meghan Elizabeth Bourne, RD, LDN, CDOE, CDCES Dietitian Medicare: Accepting Medicare Assignments Practice Location: 450 Veterans Memorial Pkwy Ste 8c, East Providence, RI 02914 Phone: 401-396-9331 Fax: 401-396-9369 | |
Ms. Lisa Ann Cabral, Dietitian Medicare: Not Enrolled in Medicare Practice Location: 318 Waterman Ave, East Providence, RI 02914 Phone: 401-435-5200 | |
Hannah Elizabeth Masse, RD LDN Dietitian Medicare: Accepting Medicare Assignments Practice Location: 450 Veterans Memorial Pkwy, East Providence, RI 02914 Phone: 401-396-9331 |