Provider Demographics
NPI:1154154664
Name:YU, PAUL (LDN, RD)
Entity type:Individual
Prefix:
First Name:PAUL
Middle Name:
Last Name:YU
Suffix:
Gender:M
Credentials:LDN, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:633 W RITTENHOUSE ST APT A1112
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19144-4314
Mailing Address - Country:US
Mailing Address - Phone:267-255-4737
Mailing Address - Fax:
Practice Address - Street 1:633 W RITTENHOUSE ST APT A1112
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19144-4314
Practice Address - Country:US
Practice Address - Phone:267-255-4737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-21
Last Update Date:2024-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN008666133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered