Provider Demographics
NPI:1649861196
Name:EVA HALDIS NUTRITION LLC
Entity type:Organization
Organization Name:EVA HALDIS NUTRITION LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EVA
Authorized Official - Middle Name:
Authorized Official - Last Name:HALDIS
Authorized Official - Suffix:
Authorized Official - Credentials:MS RD
Authorized Official - Phone:484-547-6204
Mailing Address - Street 1:453 EASTON RD
Mailing Address - Street 2:
Mailing Address - City:HORSHAM
Mailing Address - State:PA
Mailing Address - Zip Code:19044-2508
Mailing Address - Country:US
Mailing Address - Phone:484-547-6204
Mailing Address - Fax:
Practice Address - Street 1:447 EASTON RD
Practice Address - Street 2:
Practice Address - City:HORSHAM
Practice Address - State:PA
Practice Address - Zip Code:19044-2508
Practice Address - Country:US
Practice Address - Phone:484-547-6204
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-01-28
Last Update Date:2023-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty