Healthcare Provider Details

I. General information

NPI: 1740294578
Provider Name (Legal Business Name): NUTRITION SOLUTIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/28/2006
Last Update Date: 03/28/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

220 FORSGATE DR
JAMESBURG NJ
08831-1375
US

IV. Provider business mailing address

220 FORSGATE DR
JAMESBURG NJ
08831-1375
US

V. Phone/Fax

Practice location:
  • Phone: 732-966-0130
  • Fax:
Mailing address:
  • Phone: 732-966-0130
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MICHELE BERGER I
Title or Position: REGISTERED DIETITIAN
Credential: RD
Phone: 732-966-0130