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NPI Code Detail

MEDICARE: RIVANNA PAGE YOUNGPOOL RDN

MEDICARE: RIVANNA PAGE YOUNGPOOL 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
1133V00000XRegistered Dietitian

General Provider Information

NPI Number : 1104767847
Entity Type Code : Individual
Provider Name (Legal Business Name) : RIVANNA PAGE YOUNGPOOL RDN
Provider Business Mailing Address
First Line : 1732 COVENTRY RD APT 6
Second Line :
City : CLEVELAND HEIGHTS
State : OH
Zip : 44118-1152
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 10701 EAST BLVD
Second Line :
City : CLEVELAND
State : OH
Zip : 44106-1702
Country : US
Telephone Number : 216-791-3800
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/06/2026
Last Update Date : 04/06/2026

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Directions to “ RIVANNA PAGE YOUNGPOOL RDN” Practice Location

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