Provider Demographics
NPI:1437628369
Name:BROWN, VICTORIA NATALI (RDN, LDN)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:NATALI
Last Name:BROWN
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1016 MIFFLIN ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19148-1650
Mailing Address - Country:US
Mailing Address - Phone:215-528-1317
Mailing Address - Fax:
Practice Address - Street 1:1300 WOLF ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19148-2912
Practice Address - Country:US
Practice Address - Phone:215-952-9500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-20
Last Update Date:2024-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN006150133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered