Healthcare Provider Details

I. General information

NPI: 1558265165
Provider Name (Legal Business Name): PIVOT HEALTH & FITNESS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/06/2026
Last Update Date: 10/06/2026
Certification Date: 10/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 HOGATE CT
CLAYTON NJ
08312-2430
US

IV. Provider business mailing address

5 HOGATE CT
CLAYTON NJ
08312-2430
US

V. Phone/Fax

Practice location:
  • Phone: 856-562-2185
  • Fax:
Mailing address:
  • Phone: 856-562-2185
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number StateNULL

VIII. Authorized Official

Name: ASHLEIGH BURRICHTER
Title or Position: OWNER
Credential: RDN
Phone: 856-562-2185