Healthcare Provider Details

I. General information

NPI: 1366750812
Provider Name (Legal Business Name): ANDREW L RIHN RD, LDN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/17/2010
Last Update Date: 09/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3601 A ST
PHILADELPHIA PA
19134-1043
US

IV. Provider business mailing address

3601 A ST
PHILADELPHIA PA
19134-1043
US

V. Phone/Fax

Practice location:
  • Phone: 215-427-8187
  • Fax:
Mailing address:
  • Phone: 215-427-8187
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License NumberDN004395
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: