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General NPI Number Information
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NPI Number | 1811258783
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Entity Type | Organization
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Legal Business Name | NUTRITION FOR HEALTH MID-ATLANTIC, LLC
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Dates
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Enumeration Date | 06/06/2012
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Last Update Date | 06/06/2012
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Provider Practice Location Address
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Address Line | 610 OLD YORK RD SUITE 70
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City | JENKINTOWN
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State | PA
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Zip | 19046-2837
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Country | US
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Telephone | 215-350-0559
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Fax |
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Provider Business Mailing Address
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Address Line | 170 PARK AVE
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City | GETTYSBURG
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State | PA
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Zip | 17325-8410
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Country | US
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Telephone | 717-334-9949
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Fax |
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Authorized Official
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Title or Position | DIETITIAN
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Name | BARBARA EASTON VAN MEERBEKE
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Credential |
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Telephone | 717-334-9949
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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 | DN001820
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License Number State | PA
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