Healthcare Provider Details

I. General information

NPI: 1528269776
Provider Name (Legal Business Name): HERMA B CLARKE PH.D,FACN,CNS,RD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: HERMA BEATRICE CLARKE PH.D,FACN,CNS.RD

II. Dates (important events)

Enumeration Date: 05/29/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

31 CHELSEA PL
EAST ORANGE NJ
07017-1907
US

IV. Provider business mailing address

31 CHELSEA PL
EAST ORANGE NJ
07017-1907
US

V. Phone/Fax

Practice location:
  • Phone: 973-674-3008
  • Fax: 973-674-3088
Mailing address:
  • Phone: 973-674-3008
  • Fax: 973-674-3088

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number337139
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number337139
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: