Provider Demographics
NPI:1447974902
Name:MARGOLIS, JACLYN RACHEL
Entity type:Individual
Prefix:
First Name:JACLYN
Middle Name:RACHEL
Last Name:MARGOLIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:350 LINCOLN ST STE 2400
Mailing Address - Street 2:
Mailing Address - City:HINGHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02043-1579
Mailing Address - Country:US
Mailing Address - Phone:781-264-6877
Mailing Address - Fax:781-875-1454
Practice Address - Street 1:350 LINCOLN ST STE 2400
Practice Address - Street 2:
Practice Address - City:HINGHAM
Practice Address - State:MA
Practice Address - Zip Code:02043-1579
Practice Address - Country:US
Practice Address - Phone:781-264-6877
Practice Address - Fax:781-875-1454
Is Sole Proprietor?:No
Enumeration Date:2022-09-28
Last Update Date:2022-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist