Provider Demographics
NPI:1598395808
Name:PIZER, ANGELA ANN (RDN, LDN, CDM, CFPP)
Entity Type:Individual
Prefix:MRS
First Name:ANGELA
Middle Name:ANN
Last Name:PIZER
Suffix:
Gender:F
Credentials:RDN, LDN, CDM, CFPP
Other - Prefix:MISS
Other - First Name:ANGELA
Other - Middle Name:ANN
Other - Last Name:EDWARDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:101 HORSESHOE LN
Mailing Address - Street 2:
Mailing Address - City:CORRY
Mailing Address - State:PA
Mailing Address - Zip Code:16407-2303
Mailing Address - Country:US
Mailing Address - Phone:814-663-0436
Mailing Address - Fax:
Practice Address - Street 1:965 SHAMROCK LN
Practice Address - Street 2:
Practice Address - City:CORRY
Practice Address - State:PA
Practice Address - Zip Code:16407-9121
Practice Address - Country:US
Practice Address - Phone:814-664-4641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-01-26
Last Update Date:2020-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN005669133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered