Provider Demographics
NPI:1740853357
Name:TAYLOR SCHIRRA NUTRITION & WELLNESS LLC
Entity type:Organization
Organization Name:TAYLOR SCHIRRA NUTRITION & WELLNESS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCHIRRA
Authorized Official - Suffix:
Authorized Official - Credentials:MHSC, RDN, LDN
Authorized Official - Phone:570-903-4626
Mailing Address - Street 1:12015 ROSE DR
Mailing Address - Street 2:
Mailing Address - City:RANSOM TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18411-9546
Mailing Address - Country:US
Mailing Address - Phone:570-903-4626
Mailing Address - Fax:
Practice Address - Street 1:619B E DRINKER ST
Practice Address - Street 2:
Practice Address - City:DUNMORE
Practice Address - State:PA
Practice Address - Zip Code:18512-2505
Practice Address - Country:US
Practice Address - Phone:570-903-4626
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-07-21
Last Update Date:2021-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty