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NPI Code Detail

MEDICARE: CATHERINE JANE BRATKA RD, LD

MEDICARE:   CATHERINE JANE BRATKA  RD, LD
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 DietitianLD 6182OH

General Provider Information

NPI Number : 1346419207
Entity Type Code : Individual
Provider Name (Legal Business Name) : CATHERINE JANE BRATKA RD, LD
Provider Business Mailing Address
First Line : 3406 LENOX VILLAGE DR
Second Line : #244
City : FAIRLAWN
State : OH
Zip : 44333-4442
Country : US
Telephone Number : 330-714-7049
Fax Number :
Provider Business Practice Location Address
First Line : 3406 LENOX VILLAGE DR
Second Line : #244
City : FAIRLAWN
State : OH
Zip : 44333-4442
Country : US
Telephone Number : 330-714-7049
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/25/2008
Last Update Date : 11/29/2012

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Directions to “ CATHERINE JANE BRATKA RD, LD” Practice Location

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