Provider Demographics
NPI:1316767155
Name:MEASSICK, CATHERINE (MA, RD, ATC)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:
Last Name:MEASSICK
Suffix:
Gender:F
Credentials:MA, RD, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21364 CROMWELL AVE
Mailing Address - Street 2:
Mailing Address - City:FAIRVIEW PARK
Mailing Address - State:OH
Mailing Address - Zip Code:44126-2717
Mailing Address - Country:US
Mailing Address - Phone:813-484-4111
Mailing Address - Fax:
Practice Address - Street 1:21364 CROMWELL AVE
Practice Address - Street 2:
Practice Address - City:FAIRVIEW PARK
Practice Address - State:OH
Practice Address - Zip Code:44126-2717
Practice Address - Country:US
Practice Address - Phone:813-484-4111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-16
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLD.7971133VN1501X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1501XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Sports DieteticsGroup - Multi-Specialty