Provider Demographics
NPI:1669992210
Name:MARLIN, DIANA (RD, LDN)
Entity type:Individual
Prefix:MRS
First Name:DIANA
Middle Name:
Last Name:MARLIN
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:MISS
Other - First Name:DIANA
Other - Middle Name:
Other - Last Name:FIORENTINO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LDN
Mailing Address - Street 1:2200 BENJAMIN FRANKLIN PKWY APT E510
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19130-3735
Mailing Address - Country:US
Mailing Address - Phone:610-883-0582
Mailing Address - Fax:
Practice Address - Street 1:2200 BENJAMIN FRANKLIN PKWY APT E510
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19130-3735
Practice Address - Country:US
Practice Address - Phone:610-883-0582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN006187133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered