Provider Demographics
NPI:1265041776
Name:WADLINGER, MARGUERITE (RDN)
Entity Type:Individual
Prefix:MISS
First Name:MARGUERITE
Middle Name:
Last Name:WADLINGER
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:MISS
Other - First Name:MAGGIE
Other - Middle Name:
Other - Last Name:WADLINGER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RDN
Mailing Address - Street 1:1234 MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19380-1062
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1234 MAIN STREET
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19380-1062
Practice Address - Country:US
Practice Address - Phone:610-273-0202
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-07-30
Last Update Date:2020-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA86150050133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered