Provider Demographics
NPI:1134329949
Name:PCSOLYAR, NANCY K (MA, RD, LDN)
Entity Type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:K
Last Name:PCSOLYAR
Suffix:
Gender:F
Credentials:MA, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3412 TYSON RD
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073-3420
Mailing Address - Country:US
Mailing Address - Phone:610-359-1700
Mailing Address - Fax:
Practice Address - Street 1:3412 TYSON RD
Practice Address - Street 2:
Practice Address - City:NEWTOWN SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19073-3420
Practice Address - Country:US
Practice Address - Phone:610-359-1700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-19
Last Update Date:2007-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN001060133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered