Provider Demographics
NPI:1558628131
Name:TARAMELLI, MARIA (RD LDN)
Entity Type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:
Last Name:TARAMELLI
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 1:801 SCRANTON/CARBONDALE HIGHWAY
Mailing Address - Street 2:
Mailing Address - City:EYNON
Mailing Address - State:PA
Mailing Address - Zip Code:18403-1020
Mailing Address - Country:US
Mailing Address - Phone:570-876-1200
Mailing Address - Fax:570-876-1288
Practice Address - Street 1:801 SCRANTON CARBONDALE HWY
Practice Address - Street 2:
Practice Address - City:EYNON
Practice Address - State:PA
Practice Address - Zip Code:18403-1020
Practice Address - Country:US
Practice Address - Phone:570-876-1200
Practice Address - Fax:570-876-1288
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-19
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN000564133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered