Provider Demographics
NPI:1477848679
Name:SOLARUS, ALIVYANA MARIE (RDN)
Entity Type:Individual
Prefix:
First Name:ALIVYANA
Middle Name:MARIE
Last Name:SOLARUS
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:LESLIE
Other - Middle Name:
Other - Last Name:LAWTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN
Mailing Address - Street 1:543 SOUTH MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE SPINGS
Mailing Address - State:PA
Mailing Address - Zip Code:16403
Mailing Address - Country:US
Mailing Address - Phone:814-460-6215
Mailing Address - Fax:
Practice Address - Street 1:1700 PEACH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16501-2134
Practice Address - Country:US
Practice Address - Phone:814-877-4662
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-15
Last Update Date:2023-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN003610133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered