Basic Information
| Provider Information | |||||||||
| NPI: | 1417015629 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | RAMAMOORTHY | ||||||||
| FirstName: | LALITHA | ||||||||
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| Credential: | MS, RD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 21884 MERIDIAN LN | ||||||||
| Address2: | |||||||||
| City: | NOVI | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483754943 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2487674409 | ||||||||
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| Practice Location | |||||||||
| Address1: | 28455 HAGGERTY RD | ||||||||
| Address2: | |||||||||
| City: | NOVI | ||||||||
| State: | MI | ||||||||
| PostalCode: | 483772982 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2485530050 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/04/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X | MI | Y | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.