Healthcare Provider Details

I. General information

NPI: 1194932657
Provider Name (Legal Business Name): DONNA JEAN OPALKA R.D.L.D.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/16/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5230 CENTRE AVE SCHOOL OF NURSING BLDG. SUITE 141
PITTSBURGH PA
15232-1304
US

IV. Provider business mailing address

728 3RD AVE
FORD CITY PA
16226-1101
US

V. Phone/Fax

Practice location:
  • Phone: 412-623-2421
  • Fax: 412-623-2279
Mailing address:
  • Phone: 724-763-7221
  • Fax: 724-463-8131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDN000443
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: