Provider Demographics
NPI:1679509897
Name:LOGHMANI, EMILY SMITH (RD, LD, CDE)
Entity Type:Individual
Prefix:MS
First Name:EMILY
Middle Name:SMITH
Last Name:LOGHMANI
Suffix:
Gender:F
Credentials:RD, LD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 64264
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21264-4264
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:601 N CAROLINE ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287-0006
Practice Address - Country:US
Practice Address - Phone:410-955-2816
Practice Address - Fax:410-614-9586
Is Sole Proprietor?:No
Enumeration Date:2006-06-23
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH443133V00000X
MDDX2800133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD028351700Medicaid
LOMT0805Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER
MD171527ZAC3Medicare PIN