Provider Demographics
NPI:1952069338
Name:KUMMERER, ALEXANDRA (RDN)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:KUMMERER
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 HARTRANFT AVE
Mailing Address - Street 2:
Mailing Address - City:NORRISTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19401-4385
Mailing Address - Country:US
Mailing Address - Phone:610-451-5109
Mailing Address - Fax:
Practice Address - Street 1:600 W CHELTENHAM AVE
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19126-3045
Practice Address - Country:US
Practice Address - Phone:215-927-7300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-02
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN006847133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered