Provider Demographics
NPI:1225416548
Name:BROPHY, LINDA D (RD)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:D
Last Name:BROPHY
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1011 LANDIS RUSH DR
Mailing Address - Street 2:
Mailing Address - City:PERKASIE
Mailing Address - State:PA
Mailing Address - Zip Code:18944-4228
Mailing Address - Country:US
Mailing Address - Phone:215-534-9308
Mailing Address - Fax:
Practice Address - Street 1:1011 LANDIS RUSH DR
Practice Address - Street 2:
Practice Address - City:PERKASIE
Practice Address - State:PA
Practice Address - Zip Code:18944-4228
Practice Address - Country:US
Practice Address - Phone:215-534-9308
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-07
Last Update Date:2015-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN005613133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered