Healthcare Provider Details

I. General information

NPI: 1821765918
Provider Name (Legal Business Name): SAMJHANA KARKI RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2021
Last Update Date: 08/25/2021
Certification Date: 08/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

230 W JERSEY ST STE 101
ELIZABETH NJ
07202-1364
US

IV. Provider business mailing address

53 FAIRWAY AVE
BELLEVILLE NJ
07109-1463
US

V. Phone/Fax

Practice location:
  • Phone: 908-280-8571
  • Fax:
Mailing address:
  • Phone: 646-644-4205
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86038636
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: