Provider Demographics
NPI:1730674334
Name:OFALT, SARAH DENISE (RD, LDN)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:DENISE
Last Name:OFALT
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 1:116 MEMORY LN
Mailing Address - Street 2:
Mailing Address - City:TELFORD
Mailing Address - State:PA
Mailing Address - Zip Code:18969-2259
Mailing Address - Country:US
Mailing Address - Phone:267-872-6737
Mailing Address - Fax:
Practice Address - Street 1:116 MEMORY LN
Practice Address - Street 2:
Practice Address - City:TELFORD
Practice Address - State:PA
Practice Address - Zip Code:18969-2259
Practice Address - Country:US
Practice Address - Phone:267-872-6737
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-26
Last Update Date:2018-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN002150133V00000X
PA709393133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered