Provider Demographics
NPI:1215189923
Name:COHN, MARJORIE NOLAN (MS, RDN, CEDRD, CSSD)
Entity Type:Individual
Prefix:MRS
First Name:MARJORIE
Middle Name:NOLAN
Last Name:COHN
Suffix:
Gender:F
Credentials:MS, RDN, CEDRD, CSSD
Other - Prefix:MS
Other - First Name:MARJORIE
Other - Middle Name:E
Other - Last Name:NOLAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS, RDN, CEDRD, CSSD
Mailing Address - Street 1:325 WINDSOR PARK LN
Mailing Address - Street 2:
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-2704
Mailing Address - Country:US
Mailing Address - Phone:267-205-2525
Mailing Address - Fax:646-390-2220
Practice Address - Street 1:123 S BROAD ST
Practice Address - Street 2:SUITE 1641
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19109-1029
Practice Address - Country:US
Practice Address - Phone:267-205-2525
Practice Address - Fax:646-390-2220
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-14
Last Update Date:2019-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN001488133V00000X
NY006651133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered