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General NPI Number Information
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NPI Number | 1922921089
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Entity Type | Individual
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Provider Name | EMMA MARIE MONTGOMERY RD
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Gender | Female
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Dates
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Enumeration Date | 08/04/2026
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Last Update Date | 08/04/2026
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Provider Practice Location Address
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Address Line | 220 S 47TH ST APT 454
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City | PHILADELPHIA
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State | PA
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Zip | 19139-4480
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Country | US
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Telephone | 614-973-9699
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Fax |
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Provider Business Mailing Address
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Address Line | 220 S 47TH ST APT 454
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City | PHILADELPHIA
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State | PA
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Zip | 19139-4480
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Country | US
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Telephone | 614-973-9699
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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 | LD.10424
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 074.0135047
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License Number State | VT
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Taxonomy #3
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | DN010183
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License Number State | PA
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