Provider Demographics
NPI:1285407106
Name:DITTMAN, PATRICK (RD, LDN)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:
Last Name:DITTMAN
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 1:3381 OLD DARLINGTON RD
Mailing Address - Street 2:
Mailing Address - City:DARLINGTON
Mailing Address - State:PA
Mailing Address - Zip Code:16115-2733
Mailing Address - Country:US
Mailing Address - Phone:724-683-1066
Mailing Address - Fax:
Practice Address - Street 1:3381 OLD DARLINGTON RD
Practice Address - Street 2:
Practice Address - City:DARLINGTON
Practice Address - State:PA
Practice Address - Zip Code:16115-2733
Practice Address - Country:US
Practice Address - Phone:724-683-1066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-02
Last Update Date:2023-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN007545133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered