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General NPI Number Information
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NPI Number | 1417434499
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Entity Type | Individual
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Provider Name | COURTNEY KASSIS RD
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Gender | Female
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Dates
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Enumeration Date | 07/23/2018
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Last Update Date | 07/23/2018
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Provider Practice Location Address
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Address Line | 1835 MARKET ST
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City | PHILADELPHIA
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State | PA
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Zip | 19103-2968
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Country | US
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Telephone | 484-450-8488
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Fax |
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Provider Business Mailing Address
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Address Line | 5199 SPRING RIDGE DR E
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City | MACUNGIE
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State | PA
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Zip | 18062-9577
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Country | US
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Telephone | 610-739-8440
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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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