MEDICARE: AME LYNN GOLASZEWSKI RDN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	DN002350	PA

General Provider Information

NPI Number	:	1023575479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AME LYNN GOLASZEWSKI RDN

Provider Business Mailing Address
First Line	:	100 N ACADEMY AVE
Second Line	:
City	:	DANVILLE
State	:	PA
Zip	:	17822-4903
Country	:	US
Telephone Number	:	570-271-6144
Fax Number	:	570-271-6578

Provider Business Practice Location Address
First Line	:	4752 STATE ROUTE 655
Second Line	:
City	:	BELLEVILLE
State	:	PA
Zip	:	17004-9272
Country	:	US
Telephone Number	:	717-667-9030
Fax Number	:	717-667-9165

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/21/2019
Last Update Date	:	08/28/2020

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