SUDBURY RACQUET CLUB INC. NPI 1003981903

NPI Information

  • NPI: 1003981903
  • Provider Name: SUDBURY RACQUET CLUB INC.
  • Classification: Dietitian, Registered - 133V00000X
  • Entity Type: Organization
  • Doing Business As: THE LONGFELLOW CLUB
  • Address: 524 BOSTON POST RD
    THE LONGFELLOW CLUB
    WAYLAND, MA
    ZIP 01778
  • Phone: (508) 358-7355

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NPI Details

SUDBURY RACQUET CLUB INC. is a dietitian registered in Wayland, MA. The provider is a Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the purpose of disease prevention or management, or to treat or rehabilitate an illness, injury, or condition, with the use of specific, indicated physical and cognitive nutrition care services comprised of one or more of the following aspects of the NCP: nutrition assessment/reassessment, nutrition diagnosis, nutrition intervention (e.g., nutrition counseling, therapeutic diet ordering, and nutrition education) and nutrition monitoring and evaluation. SUDBURY RACQUET CLUB INC. NPI is 1003981903. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As The Longfellow Club.

The provider's business location address is:

524 BOSTON POST RD
THE LONGFELLOW CLUB
WAYLAND, MA
ZIP 01778-833
Phone: (508) 358-7355
Fax: (508) 358-3525

The provider's authorized official is Jane Polley .
The authorized official title is Dietitian and has the following contact phone number (508) 358-7355.

The enumeration date for this NPI number is 11/24/2006 and was last updated on 6/9/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101Y00000XCounselorNo
2133V00000XDietitian, RegisteredYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1763282OTHERMASSACHUSETTSTUFTS
2LG0023OTHERMASSACHUSETTSBLUE CROSS BLUE SHIELD
36300209OTHERMASSACHUSETTSUNITED HEALTH CARE
439411OTHERMASSACHUSETTSHARVARD PILGRIM HEALTH
55582051OTHERMASSACHUSETTSAETNA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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