Provider Demographics
NPI:1215346960
Name:NEWELL, EMILY (RD LDN CNSC)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:NEWELL
Suffix:
Gender:F
Credentials:RD LDN CNSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3635 N. FRONT ST., NELSON PAVILION
Mailing Address - Street 2:ST. CHRIS GASTROENTEROLOGY
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19134
Mailing Address - Country:US
Mailing Address - Phone:215-427-6538
Mailing Address - Fax:
Practice Address - Street 1:3635 N. FRONT ST., NELSON PAVILION
Practice Address - Street 2:ST. CHRIS GASTROENTEROLOGY
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134
Practice Address - Country:US
Practice Address - Phone:215-427-6538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-07
Last Update Date:2015-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CDR# 86014215133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered