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General NPI Number Information
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NPI Number | 1639534258
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Entity Type | Organization
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Legal Business Name | APPLE A DAY NUTRITION SERVICES LLC
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Dates
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Enumeration Date | 12/25/2015
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Last Update Date | 12/25/2015
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Provider Practice Location Address
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Address Line | 327 CHESTNUT ST
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City | EAST BANGOR
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State | PA
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Zip | 18013-2224
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Country | US
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Telephone | 484-294-3662
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 256
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City | MOUNT BETHEL
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State | PA
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Zip | 18343-0256
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PARTNER
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Name | SUSAN COLAVITO
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Credential | R.D. L.D.N.
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Telephone | 610-248-6644
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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 | DN005415
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License Number State | PA
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