Provider Demographics
NPI:1548666191
Name:GRABER, BRITTANY (RD, LDN)
Entity type:Individual
Prefix:
First Name:BRITTANY
Middle Name:
Last Name:GRABER
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 LARCHWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:FEASTERVILLE TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-4407
Mailing Address - Country:US
Mailing Address - Phone:215-801-6496
Mailing Address - Fax:
Practice Address - Street 1:415 LARCHWOOD AVE
Practice Address - Street 2:
Practice Address - City:FEASTERVILLE TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-4407
Practice Address - Country:US
Practice Address - Phone:215-801-6496
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-10
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA999003133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered