Provider Demographics
NPI:1326186909
Name:BELLEW, EILEEN M (MA, RD, LDN)
Entity Type:Individual
Prefix:
First Name:EILEEN
Middle Name:M
Last Name:BELLEW
Suffix:
Gender:F
Credentials:MA, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1132 BROOKWOOD LN
Mailing Address - Street 2:
Mailing Address - City:GLENOLDEN
Mailing Address - State:PA
Mailing Address - Zip Code:19036-1511
Mailing Address - Country:US
Mailing Address - Phone:610-586-2822
Mailing Address - Fax:
Practice Address - Street 1:1132 BROOKWOOD LN
Practice Address - Street 2:
Practice Address - City:GLENOLDEN
Practice Address - State:PA
Practice Address - Zip Code:19036-1511
Practice Address - Country:US
Practice Address - Phone:610-586-2822
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA833084133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered