Provider Demographics
NPI:1124465349
Name:FISCHER, NICHOLAS LOREN (RD, LDN)
Entity type:Individual
Prefix:
First Name:NICHOLAS
Middle Name:LOREN
Last Name:FISCHER
Suffix:
Gender:M
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 1:249 OLD AIRPORT RD
Mailing Address - Street 2:
Mailing Address - City:GREENSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:15601-5911
Mailing Address - Country:US
Mailing Address - Phone:412-610-0412
Mailing Address - Fax:
Practice Address - Street 1:249 OLD AIRPORT RD
Practice Address - Street 2:
Practice Address - City:GREENSBURG
Practice Address - State:PA
Practice Address - Zip Code:15601-5911
Practice Address - Country:US
Practice Address - Phone:412-610-0412
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-29
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN004936133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered