1699101428 NPI number — CAITLIN SARAH MORGAN RDN,LDN

Table of content: CAITLIN SARAH MORGAN RDN,LDN (NPI 1699101428)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699101428 NPI number — CAITLIN SARAH MORGAN RDN,LDN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
MORGAN
Provider First Name:
CAITLIN
Provider Middle Name:
SARAH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
RDN,LDN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
PETTIT
Provider Other First Name:
CAITLIN
Provider Other Middle Name:
SARAH
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
RDN, LDN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1699101428
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/09/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
POB #1
Provider Second Line Business Mailing Address:
30 MEDICAL CENTER BLVD, SUITE 205
Provider Business Mailing Address City Name:
UPLAND
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19013
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-619-7410
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
30 MEDICAL CENTER BLVD
Provider Second Line Business Practice Location Address:
SUITE 205
Provider Business Practice Location Address City Name:
UPLAND
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19013
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-619-7410
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/25/2013

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 133V00000X , with the licence number:  1063851 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 133V00000X , with the licence number: DN005237 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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