Provider Demographics
NPI:1942434477
Name:SERAFINO-CROSS, PAULA JEANNE (MS, RD, LDN)
Entity type:Individual
Prefix:MS
First Name:PAULA
Middle Name:JEANNE
Last Name:SERAFINO-CROSS
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 1:38 LONGVIEW DR
Mailing Address - Street 2:
Mailing Address - City:WILBRAHAM
Mailing Address - State:MA
Mailing Address - Zip Code:01095-2548
Mailing Address - Country:US
Mailing Address - Phone:413-949-0474
Mailing Address - Fax:
Practice Address - Street 1:2141 BOSTON RD
Practice Address - Street 2:
Practice Address - City:WILBRAHAM
Practice Address - State:MA
Practice Address - Zip Code:01095-1253
Practice Address - Country:US
Practice Address - Phone:413-241-6687
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-12
Last Update Date:2009-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA165133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered