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NPI Code Detail

MEDICARE: MS. ALEXIS CATHERINE ANDERSEN RDN

MEDICARE: MS. ALEXIS CATHERINE ANDERSEN RDN
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 DietitianPA

General Provider Information

NPI Number : 1851905269
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ALEXIS CATHERINE ANDERSEN RDN
Provider Business Mailing Address
First Line : 301 W MONUMENT AVE
Second Line :
City : HATBORO
State : PA
Zip : 19040-3131
Country : US
Telephone Number : 215-317-8116
Fax Number :
Provider Business Practice Location Address
First Line : 7959 BUSTLETON AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19152-3320
Country : US
Telephone Number : 215-745-7251
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/02/2020
Last Update Date : 09/02/2020

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