Basic Information
| Provider Information | |||||||||
| NPI: | 1538178314 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VAN DER VEER | ||||||||
| FirstName: | ABBY | ||||||||
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| Credential: | R.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 4229 EISENHOWER DR | ||||||||
| Address2: | |||||||||
| City: | BETHLEHEM | ||||||||
| State: | PA | ||||||||
| PostalCode: | 180208945 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8436934420 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2550 ELMS CENTRE RD | ||||||||
| Address2: | |||||||||
| City: | NORTH CHARLESTON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294069844 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8435727727 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/07/2006 | ||||||||
| LastUpdateDate: | 02/24/2010 | ||||||||
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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 | SC | Y | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.