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NPI Code Detail

MEDICARE: LAURA FREEMAN RD, LDN

MEDICARE:   LAURA  FREEMAN  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
1133VN1101XGerontological Nutrition Registered DietitianDN001439PA

General Provider Information

NPI Number : 1154284651
Entity Type Code : Individual
Provider Name (Legal Business Name) : LAURA FREEMAN RD, LDN
Provider Business Mailing Address
First Line : 820 WOODLAND DR
Second Line :
City : HAVERTOWN
State : PA
Zip : 19083-4512
Country : US
Telephone Number : 610-416-5039
Fax Number :
Provider Business Practice Location Address
First Line : 820 WOODLAND DR
Second Line :
City : HAVERTOWN
State : PA
Zip : 19083-4512
Country : US
Telephone Number : 610-416-5039
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/03/2025
Last Update Date : 12/03/2025

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Directions to “ LAURA FREEMAN RD, LDN” Practice Location

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