Provider Demographics
NPI:1275128886
Name:EAT WITH ERIN
Entity Type:Organization
Organization Name:EAT WITH ERIN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ERIN
Authorized Official - Middle Name:
Authorized Official - Last Name:CAROULIS
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LDN
Authorized Official - Phone:610-247-4785
Mailing Address - Street 1:113 MILARD LN
Mailing Address - Street 2:
Mailing Address - City:HAVERTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19083-5101
Mailing Address - Country:US
Mailing Address - Phone:610-247-4785
Mailing Address - Fax:
Practice Address - Street 1:101 W EAGLE RD STE 132
Practice Address - Street 2:
Practice Address - City:HAVERTOWN
Practice Address - State:PA
Practice Address - Zip Code:19083-2244
Practice Address - Country:US
Practice Address - Phone:610-247-4785
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-03-05
Last Update Date:2021-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA3897011000OtherINDIVIDUAL HMO
PA3897011000OtherIBC INDIVIDUAL PPO