MEDICARE: CYNTHIA LYNNE DINGER RD

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	DN003684	PA

General Provider Information

NPI Number	:	1174787022
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA LYNNE DINGER RD

Provider Business Mailing Address
First Line	:	PO BOX 30181
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-8181
Country	:	US
Telephone Number	:	215-496-2662
Fax Number	:

Provider Business Practice Location Address
First Line	:	12 S 23RD ST
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19103-3014
Country	:	US
Telephone Number	:	215-496-2662
Fax Number	:

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

Provider Enumeration Date	:	07/10/2008
Last Update Date	:	07/10/2008

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