MEDICARE: DR. BETH A CONLON PHD, RD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133VN1004X	Pediatric Nutrition Registered Dietitian
2	133V00000X	Registered Dietitian	01000047	NJ
3	133VN1201X	Obesity and Weight Management Nutrition Registered Dietitian

General Provider Information

NPI Number	:	1326571175
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BETH A CONLON PHD, RD

Provider Business Mailing Address
First Line	:	80 CHARLES RD
Second Line	:
City	:	STIRLING
State	:	NJ
Zip	:	07980-1032
Country	:	US
Telephone Number	:	908-331-0876
Fax Number	:

Provider Business Practice Location Address
First Line	:	2 NORTH RD
Second Line	:
City	:	WARREN
State	:	NJ
Zip	:	07059-7184
Country	:	US
Telephone Number	:	908-291-3609
Fax Number	:	866-336-9583

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2017
Last Update Date	:	06/30/2025

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