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NPI Code Detail

MEDICARE: LIV LEE MS, RDN, LDN

MEDICARE: LIV LEE MS, RDN, LDN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered DietitianDN006064PA

General Provider Information

NPI Number : 1467985937
Entity Type Code : Individual
Provider Name (Legal Business Name) : LIV LEE MS, RDN, LDN
Provider Business Mailing Address
First Line : 401 ROUTE 73 N STE 320
Second Line :
City : MARLTON
State : NJ
Zip : 08053-3426
Country : US
Telephone Number : 215-774-1166
Fax Number :
Provider Business Practice Location Address
First Line : 2000 HAMILTON ST STE 301
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19130-3874
Country : US
Telephone Number : 215-774-1166
Fax Number : 215-279-8383
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/11/2017
Last Update Date : 03/22/2023

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