Individual
MS. BRENDA MAY LAZIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MS, RD
Contact information
Practice address
6923 GREENE ST, PHILADELPHIA, PA 19119-3413
(215) 844-3514
Mailing address
6923 GREENE ST, PHILADELPHIA, PA 19119-3413
(215) 844-3514
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN000134
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
001522055
—
PA
Enumeration date
11/06/2008
Last updated
11/06/2008
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