Healthcare Provider Details
I. General information
NPI: 1871035436
Provider Name (Legal Business Name): RACHEL HERSHBERGER CNS LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 11/14/2016
Last Update Date: 08/19/2024
Certification Date: 08/19/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
237 W LANCASTER AVE STE 215
DEVON PA
19333-1585
US
IV. Provider business mailing address
237 W LANCASTER AVE STE 215
DEVON PA
19333-1585
US
V. Phone/Fax
- Phone: 484-693-0660
- Fax: 484-643-4500
- Phone: 484-693-0660
- Fax: 484-643-4500
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 133N00000X |
| Taxonomy | Nutritionist |
| License Number | DN006056 |
| License Number State | PA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: