Active NPI
Crystal D Palko, M.S., R.D., L.D.N.
- Registered Dietitian
- Ardmore, PA
National Provider Identifier
1164741922
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DN003569
- Practice address
- 110 Brookfield Ter
Ardmore, PA 19003-2805 - Phone
- (412) 401-3061
- NPI assigned
- May 19, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DN003569 | PA | Primary |
Addresses
Primary practice location
110 Brookfield Ter
Ardmore, PA 19003-2805
Mailing address
110 Brookfield Ter
Ardmore, PA 19003-2805
Phone (412) 401-3061
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN003569 | PA | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274227200000",
"number": "1164741922",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 BROOKFIELD TER",
"city": "ARDMORE",
"state": "PA",
"postal_code": "190032805",
"telephone_number": "412-401-3061"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 BROOKFIELD TER",
"city": "ARDMORE",
"state": "PA",
"postal_code": "190032805",
"telephone_number": "412-401-3061"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PALKO",
"first_name": "CRYSTAL",
"middle_name": "D",
"credential": "M.S., R.D., L.D.N.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-05-19",
"last_updated": "2010-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "PA",
"license": "DN003569",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ardmore, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.