Healthcare Provider Details

I. General information

NPI: 1245657899
Provider Name (Legal Business Name): CHELSEA RAKSZAWSKI
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHELSEA NATARIAN

II. Dates (important events)

Enumeration Date: 03/20/2014
Last Update Date: 12/06/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

211 S 9TH ST SUITE 402
PHILADELPHIA PA
19107-6810
US

IV. Provider business mailing address

211 S 9TH ST SUITE 402
PHILADELPHIA PA
19107-6810
US

V. Phone/Fax

Practice location:
  • Phone: 215-955-0020
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDN004873
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: