Healthcare Provider Details

I. General information

NPI: 1013022599
Provider Name (Legal Business Name): JANAK ROMA ANAND M.S., R.D.,LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

137 MOUNTAIN AVE
HACKETTSTOWN NJ
07840-2307
US

IV. Provider business mailing address

PO BOX 6283
BRIDGEWATER NJ
08807-0283
US

V. Phone/Fax

Practice location:
  • Phone: 908-500-2532
  • Fax:
Mailing address:
  • Phone: 908-500-2532
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1005X
TaxonomyRenal Nutrition Registered Dietitian
License Number717041
License Number StateNJ

VIII. Authorized Official

Name: JANAK R ANAND
Title or Position: PRESIDENT
Credential: M.S., R.D.
Phone: 908-500-2532