MEDICARE: AMY S. MARGULIES R.D,, C.D.E,, L,D.N.

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	DN002136	PA

General Provider Information

NPI Number	:	1225082290
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMY S. MARGULIES R.D,, C.D.E,, L,D.N.

Provider Business Mailing Address
First Line	:	6 LOCUST WAY
Second Line	:
City	:	LAFAYETTE HILL
State	:	PA
Zip	:	19444-2435
Country	:	US
Telephone Number	:	610-397-1872
Fax Number	:

Provider Business Practice Location Address
First Line	:	444 N MICHIGAN AVE STE 3400
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60611
Country	:	US
Telephone Number	:	610-308-5114
Fax Number	:

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

Provider Enumeration Date	:	05/22/2006
Last Update Date	:	08/09/2018

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