MEDICARE: HANNAH PFOHL MS, RD, 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
1	133V00000X	Registered Dietitian	DN006916	PA

General Provider Information

NPI Number	:	1730799222
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HANNAH PFOHL MS, RD, LDN

Provider Business Mailing Address
First Line	:	1136 N AMERICAN ST UNIT 114
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19123-1677
Country	:	US
Telephone Number	:	678-656-5830
Fax Number	:

Provider Business Practice Location Address
First Line	:	1136 N AMERICAN ST UNIT 114
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19123-1677
Country	:	US
Telephone Number	:	678-656-5830
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/09/2020
Last Update Date	:	08/09/2020

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