Healthcare Provider Details

I. General information

NPI: 1316003148
Provider Name (Legal Business Name): PATRICIA SCHWEIKER RD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/28/2006
Last Update Date: 01/26/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 OLD YORK RD STE 70
JENKINTOWN PA
19046-2837
US

IV. Provider business mailing address

3015 LIMEKILN PIKE
GLENSIDE PA
19038-1619
US

V. Phone/Fax

Practice location:
  • Phone: 215-896-3761
  • Fax:
Mailing address:
  • Phone: 215-896-3761
  • Fax: 215-884-3283

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDN001440
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: