Provider Demographics
NPI:1073728754
Name:DIETITIAN FOR ALL L.L.C.
Entity Type:Organization
Organization Name:DIETITIAN FOR ALL L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:LALITHA
Authorized Official - Middle Name:
Authorized Official - Last Name:RAMAMOORTHY
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD
Authorized Official - Phone:248-767-4409
Mailing Address - Street 1:21884 MERIDIAN LN
Mailing Address - Street 2:
Mailing Address - City:NOVI
Mailing Address - State:MI
Mailing Address - Zip Code:48375-4943
Mailing Address - Country:US
Mailing Address - Phone:248-767-4409
Mailing Address - Fax:
Practice Address - Street 1:22030 PARK STREET
Practice Address - Street 2:
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124
Practice Address - Country:US
Practice Address - Phone:248-767-4409
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-14
Last Update Date:2007-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, RenalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P45190Medicare PIN