Courtney Kassis, RD | |
1835 Market St, Philadelphia, PA 19103-2968 | |
(484) 450-8488 | |
Not Available |
Full Name | Courtney Kassis |
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Gender | Female |
Speciality | Dietitian, Registered |
Location | 1835 Market St, Philadelphia, Pennsylvania |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1417434499 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
133V00000X | Dietitian, Registered | (* (Not Available)) | Primary |
Provider Name | Balanced Roots, Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1982294781 PECOS PAC ID: 7517335953 Enrollment ID: O20221116001779 |
Mailing Address | Practice Location Address |
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Courtney Kassis, RD 5199 Spring Ridge Dr E, Macungie, PA 18062-9577 Ph: (610) 739-8440 | Courtney Kassis, RD 1835 Market St, Philadelphia, PA 19103-2968 Ph: (484) 450-8488 |
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