Provider Demographics
NPI:1538678198
Name:ROBINSON, MARY ELISABETH (RD, LDN)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:ELISABETH
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:MARY
Other - Middle Name:ELISABETH
Other - Last Name:ECKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LDN
Mailing Address - Street 1:41 W TEMPLE AVE APT B4
Mailing Address - Street 2:
Mailing Address - City:SELLERSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18960-2381
Mailing Address - Country:US
Mailing Address - Phone:412-613-8897
Mailing Address - Fax:
Practice Address - Street 1:217 CHURCH ROAD
Practice Address - Street 2:
Practice Address - City:NORTH WALES
Practice Address - State:PA
Practice Address - Zip Code:19454
Practice Address - Country:US
Practice Address - Phone:267-613-8246
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-27
Last Update Date:2017-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN006018133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered