MEDICARE: TESS SACCHETTI MS, RDN, 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
1	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1205548146
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TESS SACCHETTI MS, RDN, LDN

Provider Business Mailing Address
First Line	:	1019 MAPLE ST
Second Line	:
City	:	SPRING BROOK TOWNSHIP
State	:	PA
Zip	:	18444-6335
Country	:	US
Telephone Number	:	570-906-1387
Fax Number	:

Provider Business Practice Location Address
First Line	:	1019 MAPLE ST
Second Line	:
City	:	SPRING BROOK TOWNSHIP
State	:	PA
Zip	:	18444-6335
Country	:	US
Telephone Number	:	570-906-1387
Fax Number	:

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

Provider Enumeration Date	:	12/22/2022
Last Update Date	:	12/22/2022

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