Provider Demographics
NPI:1427758440
Name:BARTOSIEWICZ, SAMANTHA LYN (RDN)
Entity type:Individual
Prefix:MRS
First Name:SAMANTHA
Middle Name:LYN
Last Name:BARTOSIEWICZ
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2284 KINGSTON PIKE
Mailing Address - Street 2:
Mailing Address - City:CIRCLEVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43113-9714
Mailing Address - Country:US
Mailing Address - Phone:614-961-0367
Mailing Address - Fax:
Practice Address - Street 1:4359 E ENON RD
Practice Address - Street 2:
Practice Address - City:YELLOW SPRINGS
Practice Address - State:OH
Practice Address - Zip Code:45387-9708
Practice Address - Country:US
Practice Address - Phone:937-206-1131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-03-08
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered