Healthcare Provider Details

I. General information

NPI: 1396106902
Provider Name (Legal Business Name): BRITTANY LEIGH PIZIO MA, RD, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: BRITTANY LEIGH FORD MA, RD, LDN

II. Dates (important events)

Enumeration Date: 03/09/2016
Last Update Date: 03/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

475 SPRING LN
PHILADELPHIA PA
19128-3918
US

IV. Provider business mailing address

475 SPRING LN
PHILADELPHIA PA
19128-3918
US

V. Phone/Fax

Practice location:
  • Phone: 215-482-5353
  • Fax:
Mailing address:
  • Phone: 215-482-5353
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDN005048
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: