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General NPI Number Information
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NPI Number | 1437018413
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Entity Type | Organization
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Legal Business Name | SEL ROSE LLC
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Dates
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Enumeration Date | 01/16/2026
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Last Update Date | 02/01/2026
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Provider Practice Location Address
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Address Line | 3580 INDIAN QUEEN LN
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City | PHILADELPHIA
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State | PA
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Zip | 19129-1540
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Country | US
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Telephone | 484-754-6427
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 27738
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City | PHILADELPHIA
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State | PA
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Zip | 19118-0738
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Country | US
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Telephone | 484-754-6427
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Fax |
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Authorized Official
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Title or Position | DIETITIAN/NUTRITIONIST
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Name | LISA NORRIS
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Credential | RD LDN
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Telephone | 484-754-6427
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133VN1004X
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Taxonomy Name | Pediatric Nutrition Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 133VN1101X
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Taxonomy Name | Gerontological Nutrition Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 133VN1201X
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Taxonomy Name | Obesity and Weight Management Nutrition Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 133VN1006X
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Taxonomy Name | Metabolic Nutrition Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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Taxonomy #7
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Taxonomy Code | 133VN1005X
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Taxonomy Name | Renal Nutrition Registered Dietitian
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License Number |
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License Number State |
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Taxonomy #8
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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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