| Doctor Name: | MRS. SUSAN GENEROSE |
| NPI Number: | 1578843827 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | R.D. |
| License Number: | DN000681 |
| Business Practice Address: | 135 Lafayette Ave Palmerton, PA - 180711518 |
| Business Phone Number: | 6108261150 |
| Business Fax Number: | 6108261211 |
| Mailing Address: | 10 Heritage Cir, HAZLE TOWNSHIP |
| State: | PA |
| Postal Code: | 182022905 |
| Phone Number: | 5704015345 |
| Fax Number: | 6108261211 |
| NPI Enumeration Date: | 08/18/2011 |
| NPI Last Update Date: | 08/18/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133VN1006X |
| License Number: | DN000681 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | PA |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Dietitian, Registered |
| Taxonomy Specialization: | Nutrition, Metabolic |
| Taxonomy Definition: | |