Provider Demographics
NPI:1982598165
Name:FRIDLEY, DANIEL (RDN, LDN)
Entity type:Individual
Prefix:
First Name:DANIEL
Middle Name:
Last Name:FRIDLEY
Suffix:
Gender:M
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5750 BAUM BLVD # 306
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15206-3793
Mailing Address - Country:US
Mailing Address - Phone:412-593-2048
Mailing Address - Fax:844-311-7396
Practice Address - Street 1:1813 GOLDEN MILE HWY # 100
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15239-2827
Practice Address - Country:US
Practice Address - Phone:412-593-2048
Practice Address - Fax:844-311-7396
Is Sole Proprietor?:No
Enumeration Date:2025-06-04
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN007216133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered