Healthcare Provider Details

I. General information

NPI: 1952538266
Provider Name (Legal Business Name): DARLENE SUSAN PRZYBYSZEWSKI RD, LDN, CDE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/12/2009
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3330 PEACH ST STE 211
ERIE PA
16508-2772
US

IV. Provider business mailing address

104 E 2ND ST FL 4
ERIE PA
16507-1532
US

V. Phone/Fax

Practice location:
  • Phone: 814-877-5484
  • Fax: 814-877-5489
Mailing address:
  • Phone: 814-877-7157
  • Fax: 814-877-2844

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDN000452
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: