Provider Demographics
NPI:1609439595
Name:MALLOWE, ALLISON M (MA, RD, LDN)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:M
Last Name:MALLOWE
Suffix:
Gender:F
Credentials:MA, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 CHESTNUT AVE
Mailing Address - Street 2:
Mailing Address - City:NARBERTH
Mailing Address - State:PA
Mailing Address - Zip Code:19072-2406
Mailing Address - Country:US
Mailing Address - Phone:610-247-0800
Mailing Address - Fax:
Practice Address - Street 1:123 S BROAD ST STE 1641
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19109-1027
Practice Address - Country:US
Practice Address - Phone:347-474-9019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-17
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered