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NPI Code Detail

MEDICARE: YUMMY BODY NUTRITION

MEDICARE: YUMMY BODY NUTRITION
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 DietitianDN005718PA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11194193425OTHERPACOMMERCIAL INSURANCE

General Provider Information

NPI Number : 1669986204
Entity Type Code : Organization
Provider Name (Legal Business Name) : YUMMY BODY NUTRITION
Provider Business Mailing Address
First Line : 600 HAVERFORD RD STE 200
Second Line :
City : HAVERFORD
State : PA
Zip : 19041-1139
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 325 CHESTNUT ST STE 800
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19106-2608
Country : US
Telephone Number : 484-416-1090
Fax Number :
Authorized Official
Title or Position : OWNER
Name : MY HA NGUYEN
Credential :
Telephone Number : 215-285-0395
Provider Enumeration Date : 11/17/2017
Last Update Date : 03/17/2018

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Directions to “YUMMY BODY NUTRITION ” Practice Location

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