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NPI Code Detail

MEDICARE: DIABETES & NUTRITION COUNSELING SERVICES LLC

MEDICARE: DIABETES & NUTRITION COUNSELING SERVICES LLC
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 DietitianDN0000589PA

General Provider Information

NPI Number : 1568787646
Entity Type Code : Organization
Provider Name (Legal Business Name) : DIABETES & NUTRITION COUNSELING SERVICES LLC
Provider Business Mailing Address
First Line : 425 BRIGGS RD
Second Line :
City : LANGHORNE
State : PA
Zip : 19047-8228
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2346 TRENTON RD
Second Line : SUITE C
City : LEVITTOWN
State : PA
Zip : 19056-1423
Country : US
Telephone Number : 215-741-4680
Fax Number : 215-741-4683
Authorized Official
Title or Position : OWNER
Name : LESLEY G KELNER
Credential : RD, LDN, CDE
Telephone Number : 215-741-4680
Provider Enumeration Date : 04/01/2010
Last Update Date : 04/01/2010

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