Provider Demographics
NPI:1447616487
Name:STALTE, SUSAN MAUREEN (RD, LDN)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:MAUREEN
Last Name:STALTE
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 MEADOWBROOK LN
Mailing Address - Street 2:
Mailing Address - City:CHALFONT
Mailing Address - State:PA
Mailing Address - Zip Code:18914-2822
Mailing Address - Country:US
Mailing Address - Phone:267-337-5465
Mailing Address - Fax:
Practice Address - Street 1:81 MEADOWBROOK LN
Practice Address - Street 2:
Practice Address - City:CHALFONT
Practice Address - State:PA
Practice Address - Zip Code:18914-2822
Practice Address - Country:US
Practice Address - Phone:267-337-5465
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-06
Last Update Date:2016-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN005802251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health