Provider Demographics
NPI:1225624737
Name:APPLIED DIETETICS LLC
Entity Type:Organization
Organization Name:APPLIED DIETETICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTINA
Authorized Official - Middle Name:
Authorized Official - Last Name:RICCARDO
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:267-907-8350
Mailing Address - Street 1:289 MAPLE POINT DR
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-1449
Mailing Address - Country:US
Mailing Address - Phone:267-907-8350
Mailing Address - Fax:215-860-2266
Practice Address - Street 1:829 2ND STREET PIKE FL 1
Practice Address - Street 2:
Practice Address - City:RICHBORO
Practice Address - State:PA
Practice Address - Zip Code:18954-1067
Practice Address - Country:US
Practice Address - Phone:267-907-8350
Practice Address - Fax:215-860-2266
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-18
Last Update Date:2020-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty