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General NPI Number Information
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NPI Number | 1386253318
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Entity Type | Organization
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Legal Business Name | PORRAZZA NUTRITION LLC
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Dates
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Enumeration Date | 07/27/2020
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Last Update Date | 05/20/2022
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Provider Practice Location Address
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Address Line | 601 WARWICK RD
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City | FAIRLESS HILLS
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State | PA
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Zip | 19030-3106
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Country | US
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Telephone | 215-821-7045
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Fax | 610-200-5782
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Provider Business Mailing Address
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Address Line | 1331 EAST LINCOLN HIGHWAY #216
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City | LEVITTOWN
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State | PA
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Zip | 19056
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Country | US
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Telephone | 215-821-7045
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Fax | 610-200-5782
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Authorized Official
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Title or Position | REGISTERED DIETITIAN
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Name | FELICIA PORRAZZA
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Credential | MDA, RDN, LDN, CPT
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Telephone | 215-821-7045
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State |
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