1356748016 NPI number — MRS. PATRICIA C ST. LEDGER MS, RD, LDN

Table of content: MRS. PATRICIA C ST. LEDGER MS, RD, LDN (NPI 1356748016)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1356748016 NPI number — MRS. PATRICIA C ST. LEDGER MS, RD, LDN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ST. LEDGER
Provider First Name:
PATRICIA
Provider Middle Name:
C
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
MS, RD, LDN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CASEY
Provider Other First Name:
PATRICIA
Provider Other Middle Name:
M
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MS, RD, LDN
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1356748016
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/10/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
190 W. GERMANTOWN PIKE
Provider Second Line Business Mailing Address:
SUITE 155
Provider Business Mailing Address City Name:
EAST NORRITON
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19401
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-229-9060
Provider Business Mailing Address Fax Number:
610-229-9060

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
190 W. GERMANTOWN PIKE
Provider Second Line Business Practice Location Address:
SUITE 155
Provider Business Practice Location Address City Name:
EAST NORRITON
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19401
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-229-9060
Provider Business Practice Location Address Fax Number:
610-229-9060
Provider Enumeration Date:
11/24/2014

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:  1086102 , 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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