Provider Demographics
NPI:1023575479
Name:GOLASZEWSKI, AME LYNN (RDN)
Entity Type:Individual
Prefix:
First Name:AME
Middle Name:LYNN
Last Name:GOLASZEWSKI
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:570-271-6578
Practice Address - Street 1:4752 STATE ROUTE 655
Practice Address - Street 2:
Practice Address - City:BELLEVILLE
Practice Address - State:PA
Practice Address - Zip Code:17004-9272
Practice Address - Country:US
Practice Address - Phone:717-667-9030
Practice Address - Fax:717-667-9165
Is Sole Proprietor?:No
Enumeration Date:2019-02-21
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN002350133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered