MEDICARE: MS. SADHANA RAMANATHAN BIENZEN MS, RD, CD

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	839004	WI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	839004	OTHER	WI	RD REGISTRATION #

General Provider Information

NPI Number	:	1942215801
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. SADHANA RAMANATHAN BIENZEN MS, RD, CD

Provider Business Mailing Address
First Line	:	4214 WEST CARMEL DR
Second Line	:
City	:	FRANKLIN
State	:	WI
Zip	:	53132-9482
Country	:	US
Telephone Number	:	414-467-7947
Fax Number	:	414-423-8140

Provider Business Practice Location Address
First Line	:	4214 W CARMEL DR
Second Line	:
City	:	FRANKLIN
State	:	WI
Zip	:	53132-9482
Country	:	US
Telephone Number	:	414-467-7947
Fax Number	:	414-423-8140

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

Provider Enumeration Date	:	07/29/2006
Last Update Date	:	06/10/2009

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