Provider Demographics
NPI:1982069100
Name:RICHTER, GIA MARIE (RDN, LDN)
Entity Type:Individual
Prefix:
First Name:GIA
Middle Name:MARIE
Last Name:RICHTER
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:GIA
Other - Middle Name:MARIE
Other - Last Name:D'ANGELIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN,LDN
Mailing Address - Street 1:9956 WISTARIA ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19115-1718
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9956 WISTARIA ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19115-1718
Practice Address - Country:US
Practice Address - Phone:267-973-4524
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-12-15
Last Update Date:2015-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN004639133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered