Provider Demographics
NPI:1174252555
Name:BRANIGAN, LUDMILLA
Entity Type:Individual
Prefix:
First Name:LUDMILLA
Middle Name:
Last Name:BRANIGAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2016 PACKARD AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGDON VALLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19006-6413
Mailing Address - Country:US
Mailing Address - Phone:215-519-7564
Mailing Address - Fax:
Practice Address - Street 1:2016 PACKARD AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGDON VALLEY
Practice Address - State:PA
Practice Address - Zip Code:19006-6413
Practice Address - Country:US
Practice Address - Phone:215-519-7564
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist