Provider Demographics
NPI:1275276545
Name:MEEHAN, CAROLINE (RD)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:
Last Name:MEEHAN
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 1:700 SPRUCE ST STE 400
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19106-4027
Mailing Address - Country:US
Mailing Address - Phone:215-829-5725
Mailing Address - Fax:215-829-7712
Practice Address - Street 1:700 SPRUCE ST STE 400
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19106-4027
Practice Address - Country:US
Practice Address - Phone:215-829-5725
Practice Address - Fax:215-829-7712
Is Sole Proprietor?:No
Enumeration Date:2022-04-15
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered