Provider Demographics
NPI:1942846852
Name:FASCIANA, EMILY RICHTERS (MS RDN LDN)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:RICHTERS
Last Name:FASCIANA
Suffix:
Gender:F
Credentials:MS RDN LDN
Other - Prefix:
Other - First Name:EMILY
Other - Middle Name:RENEE
Other - Last Name:RICHTERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS RDN LDN
Mailing Address - Street 1:1111 E END BLVD
Mailing Address - Street 2:
Mailing Address - City:WILKES BARRE
Mailing Address - State:PA
Mailing Address - Zip Code:18711-0030
Mailing Address - Country:US
Mailing Address - Phone:570-824-3521
Mailing Address - Fax:
Practice Address - Street 1:1111 E END BLVD
Practice Address - Street 2:
Practice Address - City:WILKES BARRE
Practice Address - State:PA
Practice Address - Zip Code:18711-0030
Practice Address - Country:US
Practice Address - Phone:570-824-3521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-26
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN005149133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty