Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Philly Dietitian LLC

Organization Registered Dietitian · NPI 1114390085

Philly Dietitian LLC is a Registered Dietitian in Philadelphia, Pennsylvania. Licensed in Pennsylvania. Registered with an NPI since 2015.

Licensed in
PA
In the registry since
2015
What do these letters mean?
LLC — Limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

1909 Green St
Philadelphia, PA 19130-3244
Phone: (717) 203-9728
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Dietitian (primary) Taxonomy 133V00000X · Licence DN004553 (PA)

Record details

NPI number1114390085
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Theresa Shank — Registered Dietitian · (717) 203-9728
NPI enumeratedNovember 2, 2015
Last updated in NPPESNovember 2, 2015
Mailing address1909 Green St, Philadelphia, PA 19130-3244

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