Provider Demographics
NPI:1801160973
Name:AGRESTI, HELEN ANNE (RD)
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:ANNE
Last Name:AGRESTI
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 HILLTOP RD
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16509-2312
Mailing Address - Country:US
Mailing Address - Phone:814-881-8483
Mailing Address - Fax:
Practice Address - Street 1:431 HILLTOP RD
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16509-2312
Practice Address - Country:US
Practice Address - Phone:814-881-8483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-06
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA848023133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered