Provider Demographics
NPI:1043499486
Name:REBECCA BITZER MS RD & ASSOCIATES INC
Entity type:Organization
Organization Name:REBECCA BITZER MS RD & ASSOCIATES INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-OWNDER
Authorized Official - Prefix:MS
Authorized Official - First Name:KLARA
Authorized Official - Middle Name:
Authorized Official - Last Name:KNEZEVIC
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:301-474-2499
Mailing Address - Street 1:6301 IVY LN STE 410
Mailing Address - Street 2:
Mailing Address - City:GREENBELT
Mailing Address - State:MD
Mailing Address - Zip Code:20770-6357
Mailing Address - Country:US
Mailing Address - Phone:301-474-2499
Mailing Address - Fax:301-474-5943
Practice Address - Street 1:6301 IVY LN STE 410
Practice Address - Street 2:
Practice Address - City:GREENBELT
Practice Address - State:MD
Practice Address - Zip Code:20770-6357
Practice Address - Country:US
Practice Address - Phone:301-474-2499
Practice Address - Fax:301-474-5943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-02
Last Update Date:2022-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00045133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
G02262Medicare PIN