Organization
CHILDREN'S HOSPITAL OF PHILADELPHIA
Active
Parent organization
CHILDREN'S HOSPITAL OF PHILADELPHIA
Other names
Kennett Square Healthy Weight
Organization subpart
Yes
Provider details
NPI number
Legal business name
CHILDREN'S HOSPITAL OF PHILADELPHIA
Authorized official
GALENA MOWDAY (CRS)
(215) 590-2897
Entity
Organization
Contact information
Practice address
817 E BALTIMORE PIKE. SUITE A, KENNETT SQUARE, PA 19348-1929
(610) 444-0113
(610) 444-0744
Mailing address
3401 CIVIC CENTER BLVD, PHILADELPHIA, PA 19104-4319
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
—
—
133V00000X
Registered Dietitian
—
—
133VN1004X
Pediatric Nutrition Registered Dietitian
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1007709910121
—
PA
Enumeration date
10/06/2020
Last updated
02/10/2023
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