Provider Demographics
NPI:1679260541
Name:DOSYAK, ANNA (RD, LDN)
Entity type:Individual
Prefix:
First Name:ANNA
Middle Name:
Last Name:DOSYAK
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2575 GALLOWAY RD
Mailing Address - Street 2:
Mailing Address - City:BENSALEM
Mailing Address - State:PA
Mailing Address - Zip Code:19020-2314
Mailing Address - Country:US
Mailing Address - Phone:215-939-6908
Mailing Address - Fax:
Practice Address - Street 1:2575 GALLOWAY RD
Practice Address - Street 2:
Practice Address - City:BENSALEM
Practice Address - State:PA
Practice Address - Zip Code:19020-2314
Practice Address - Country:US
Practice Address - Phone:215-939-6908
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-20
Last Update Date:2023-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN008037133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered