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NPI Code Detail

MEDICARE: MS. LAUREN CARVER RD, LDN

MEDICARE: MS. LAUREN CARVER RD, LDN
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
1133V00000XRegistered Dietitian

General Provider Information

NPI Number : 1053747568
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LAUREN CARVER RD, LDN
Provider Business Mailing Address
First Line : 258 FOUNTAIN ST
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19128-4508
Country : US
Telephone Number : 484-574-9574
Fax Number :
Provider Business Practice Location Address
First Line : 8151 RIDGE AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19128-2902
Country : US
Telephone Number : 215-487-2500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/17/2013
Last Update Date : 09/17/2013

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