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NPI Code Detail

MEDICARE: KRISTINA LEWANDOWSKI RD

MEDICARE: KRISTINA LEWANDOWSKI 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
1133V00000XRegistered DietitianL005662NC

General Provider Information

NPI Number : 1417420829
Entity Type Code : Individual
Provider Name (Legal Business Name) : KRISTINA LEWANDOWSKI RD
Provider Business Mailing Address
First Line : 2010 PALADIN CT APT 206
Second Line :
City : BELMONT
State : NC
Zip : 28012-3677
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 11709 FRUEHAUF DR
Second Line :
City : CHARLOTTE
State : NC
Zip : 28273-7284
Country : US
Telephone Number : 440-785-2954
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/08/2019
Last Update Date : 01/08/2019

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