Provider Demographics
NPI:1568787646
Name:DIABETES & NUTRITION COUNSELING SERVICES LLC
Entity Type:Organization
Organization Name:DIABETES & NUTRITION COUNSELING SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LESLEY
Authorized Official - Middle Name:G
Authorized Official - Last Name:KELNER
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LDN, CDE
Authorized Official - Phone:215-741-4680
Mailing Address - Street 1:425 BRIGGS RD
Mailing Address - Street 2:
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047-8228
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2346 TRENTON RD
Practice Address - Street 2:SUITE C
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19056-1423
Practice Address - Country:US
Practice Address - Phone:215-741-4680
Practice Address - Fax:215-741-4683
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-01
Last Update Date:2010-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN0000589133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty