Healthcare Provider Details

I. General information

NPI: 1609180801
Provider Name (Legal Business Name): JANET M LITWACK M.S., R.D., L.D.N
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JANET M GOLDENBERG

II. Dates (important events)

Enumeration Date: 07/29/2010
Last Update Date: 07/29/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9805 DAMERON DR ROOM #20
SILVER SPRING MD
20902-5717
US

IV. Provider business mailing address

PO BOX 17112
BALTIMORE MD
21297-1112
US

V. Phone/Fax

Practice location:
  • Phone: 301-754-7848
  • Fax: 301-754-8501
Mailing address:
  • Phone: 301-498-2922
  • Fax: 301-498-3074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDX2680
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: