Provider Demographics
NPI:1669424727
Name:WUHL, LIZA RESURRECCION (MS, RD, LDN, CNSD)
Entity type:Individual
Prefix:MRS
First Name:LIZA
Middle Name:RESURRECCION
Last Name:WUHL
Suffix:
Gender:F
Credentials:MS, RD, LDN, CNSD
Other - Prefix:
Other - First Name:LIZA
Other - Middle Name:B
Other - Last Name:RESURRECCION
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, RD, LDN, CNSD
Mailing Address - Street 1:182 GAY ST
Mailing Address - Street 2:#1101
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19128-4801
Mailing Address - Country:US
Mailing Address - Phone:914-261-2481
Mailing Address - Fax:
Practice Address - Street 1:RED LION ROAD AND KNIGHTS ROAD
Practice Address - Street 2:NUTRITION CENTER
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19145
Practice Address - Country:US
Practice Address - Phone:215-612-4863
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN003108133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered