Healthcare Provider Details

I. General information

NPI: 1497112718
Provider Name (Legal Business Name): LINDSAY V MAURER RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2016
Last Update Date: 10/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 DIAMOND HILL RD
BERKELEY HEIGHTS NJ
07922-2104
US

IV. Provider business mailing address

23 NORTHRIDGE DR
FLORHAM PARK NJ
07932-1500
US

V. Phone/Fax

Practice location:
  • Phone: 908-277-8667
  • Fax: 908-277-8707
Mailing address:
  • Phone: 973-886-0689
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number86003507
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86003507
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: