Provider Demographics
NPI:1649715178
Name:FINKELSTEIN, MARLEE (MED, MS, RD, LDN)
Entity type:Individual
Prefix:
First Name:MARLEE
Middle Name:
Last Name:FINKELSTEIN
Suffix:
Gender:F
Credentials:MED, 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 1:2219 N STONE RIDGE LN
Mailing Address - Street 2:
Mailing Address - City:VILLANOVA
Mailing Address - State:PA
Mailing Address - Zip Code:19085-1727
Mailing Address - Country:US
Mailing Address - Phone:484-802-3366
Mailing Address - Fax:
Practice Address - Street 1:2219 N STONE RIDGE LN
Practice Address - Street 2:
Practice Address - City:VILLANOVA
Practice Address - State:PA
Practice Address - Zip Code:19085-1727
Practice Address - Country:US
Practice Address - Phone:484-802-3366
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-19
Last Update Date:2016-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN005931133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered