Individual provider Active NPI

Brenda May Lazin, MS, RD

  • Registered Dietitian
  • Philadelphia, PA
National Provider Identifier
1396999090
Registry record updated Nov 6, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
DN000134 Issued in PA
Practice address
6923 Greene St
Philadelphia, PA 19119-3413
Phone
(215) 844-3514
NPI assigned
Nov 6, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 6, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X DN000134 PA Primary

Addresses

Primary practice location

6923 Greene St
Philadelphia, PA 19119-3413

Mailing address

6923 Greene St
Philadelphia, PA 19119-3413
Phone (215) 844-3514

Other identifiers 1

IdentifierTypeStateIssuer
001522055MedicaidPA

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

LicenseStateTypeSpecialty
DN000134PAMDRegistered Dietitian

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1225929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1225929600000",
    "number": "1396999090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6923 GREENE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191193413",
            "telephone_number": "215-844-3514"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6923 GREENE ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191193413",
            "telephone_number": "215-844-3514"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAZIN",
        "first_name": "BRENDA",
        "middle_name": "MAY",
        "name_prefix": "Ms.",
        "credential": "MS, RD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-11-06",
        "last_updated": "2008-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN000134",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "001522055",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Philadelphia, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.