Healthcare Provider Details

I. General information

NPI: 1598257883
Provider Name (Legal Business Name): EMILY RYKACZEWSKI MS, RDN, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2018
Last Update Date: 06/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24 VETERANS SQ
MEDIA PA
19063-3155
US

IV. Provider business mailing address

24 RUCKER RD
RICHBORO PA
18954-1000
US

V. Phone/Fax

Practice location:
  • Phone: 610-514-9849
  • Fax: 610-783-3600
Mailing address:
  • Phone: 215-609-6542
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDN006501
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: