Provider Demographics
NPI:1659452035
Name:MASLONIK, JANE A (RD LDN)
Entity Type:Individual
Prefix:MS
First Name:JANE
Middle Name:A
Last Name:MASLONIK
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 1:206 HOMESTEAD LN
Mailing Address - Street 2:
Mailing Address - City:PATTON
Mailing Address - State:PA
Mailing Address - Zip Code:16668-5119
Mailing Address - Country:US
Mailing Address - Phone:814-674-3610
Mailing Address - Fax:
Practice Address - Street 1:290 HAIDA AVENUE
Practice Address - Street 2:
Practice Address - City:HASTINGS
Practice Address - State:PA
Practice Address - Zip Code:16646
Practice Address - Country:US
Practice Address - Phone:814-247-3215
Practice Address - Fax:814-247-3119
Is Sole Proprietor?:No
Enumeration Date:2006-10-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN001972133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered