Provider Demographics
NPI:1760621437
Name:ANDERSEN, ERIN M (MS, RD, LDN)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:M
Last Name:ANDERSEN
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1761 ROCKWELL RD
Mailing Address - Street 2:
Mailing Address - City:ABINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:19001-1021
Mailing Address - Country:US
Mailing Address - Phone:973-919-7487
Mailing Address - Fax:
Practice Address - Street 1:1340 SWEDESFORD RD
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:PA
Practice Address - Zip Code:19312-1087
Practice Address - Country:US
Practice Address - Phone:610-240-9916
Practice Address - Fax:610-240-9809
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-19
Last Update Date:2012-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN003861133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered