Provider Demographics
NPI:1881259455
Name:LENGEL, ELIZABETH C (RD, LD)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:C
Last Name:LENGEL
Suffix:
Gender:F
Credentials:RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9207 VICTORIA LN
Mailing Address - Street 2:
Mailing Address - City:NORTH RIDGEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44039-8584
Mailing Address - Country:US
Mailing Address - Phone:216-337-9735
Mailing Address - Fax:
Practice Address - Street 1:1801 CENTURY PARK E FL 24
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90067-2302
Practice Address - Country:US
Practice Address - Phone:888-219-5299
Practice Address - Fax:888-219-9817
Is Sole Proprietor?:No
Enumeration Date:2019-05-08
Last Update Date:2019-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH874870133V00000X
OH847870133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered