Provider Demographics
NPI:1194104760
Name:4E WELLNESS
Entity type:Organization
Organization Name:4E WELLNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:BARBARA
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAPPETTA
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:215-806-2955
Mailing Address - Street 1:105 GARTH RD
Mailing Address - Street 2:
Mailing Address - City:ORELAND
Mailing Address - State:PA
Mailing Address - Zip Code:19075-1905
Mailing Address - Country:US
Mailing Address - Phone:215-806-2955
Mailing Address - Fax:
Practice Address - Street 1:105 GARTH RD
Practice Address - Street 2:
Practice Address - City:ORELAND
Practice Address - State:PA
Practice Address - Zip Code:19075-1905
Practice Address - Country:US
Practice Address - Phone:215-806-2955
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-05-28
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN002744133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty