Susan Colavito, MS, RD, LDN
Individual provider Active NPI Registered Dietitian · East Bangor, PA
NPI 1528186129 · NPPES record last updated Dec 17, 2015
Key facts
- NPI
- 1528186129
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- DN005415 (PA)
- Practice address
- 327 Chestnut St
East Bangor, PA 18013-2224 - Phone
- (610) 248-6644
- NPI assigned
- Mar 26, 2007
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| DN005415 | PA | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Apple a Day Nutrition Services LLC | Dietitian, Registered | Past | Accepting new patients |
| Marjorie Nolan Cohn LLC | Dietitian, Registered | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | DN005415 | PA | Yes |
Addresses
Primary practice location
327 Chestnut St
East Bangor, PA 18013-2224
Mailing address
327 Chestnut St
East Bangor, PA 18013-2224
Phone (610) 248-6644
Other providers in East Bangor, PA
All providers in East Bangor, PA · Registered Dietitian in Pennsylvania
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 17, 2015. 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.