Amy Deahl-Greenlaw, RDN
Individual provider Active NPI Nutritionist · Berwyn, PA
NPI 1124480587 · NPPES record last updated Mar 24, 2016
Key facts
- NPI
- 1124480587
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nutritionist 133N00000X
- License
- DN000633 (PA)
- Practice address
- 581 Watford LN
Berwyn, PA 19312-1750 - Phone
- (610) 220-6085
- NPI assigned
- Mar 24, 2016
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN000633 | PA | MD | Nutritionist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nutritionist | 133N00000X | DN000633 | PA | Yes |
Addresses
Primary practice location
581 Watford LN
Berwyn, PA 19312-1750
Mailing address
581 Watford LN
Berwyn, PA 19312-1750
Phone (610) 220-6085
Other providers in Berwyn, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 24, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.