Active NPI
Susan Rudalavage, NUTRITIONIST
- Registered Dietitian
- Scranton, PA
National Provider Identifier
1619092970
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- DN003044
- Practice address
- 640 Madison Avenue
Scranton, PA 18510 - Phone
- (570) 941-0630
- Fax
- (570) 941-0648
- NPI assigned
- Mar 19, 2007
- Sex
- Female
- Sole proprietor
- No
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 | DN003044 | PA | Primary |
Addresses
Primary practice location
640 Madison Avenue
Scranton, PA 18510
Mailing address
746 Jefferson Avenue
Scranton, PA 18510
Phone (570) 343-2383
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Eat and Thrive Now LLC | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174262400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1619092970",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "746 JEFFERSON AVENUE",
"city": "SCRANTON",
"state": "PA",
"postal_code": "18510",
"telephone_number": "570-343-2383",
"fax_number": "570-963-6133"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "640 MADISON AVENUE",
"city": "SCRANTON",
"state": "PA",
"postal_code": "18510",
"telephone_number": "570-941-0630",
"fax_number": "570-941-0648"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RUDALAVAGE",
"first_name": "SUSAN",
"credential": "NUTRITIONIST",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-19",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "PA",
"license": "DN003044",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Scranton, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.