Provider Demographics
NPI:1841958147
Name:HANLON, BARBARA ELLEN (RDN)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:ELLEN
Last Name:HANLON
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 1:21 HORSESHOE LN
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19073-2924
Mailing Address - Country:US
Mailing Address - Phone:315-882-2647
Mailing Address - Fax:
Practice Address - Street 1:589 SKIPPACK PIKE STE 400
Practice Address - Street 2:
Practice Address - City:BLUE BELL
Practice Address - State:PA
Practice Address - Zip Code:19422-2159
Practice Address - Country:US
Practice Address - Phone:315-882-2647
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-12-03
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1283783133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1283783OtherNYS REGISTRATION