Healthcare Provider Details

I. General information

NPI: 1154094977
Provider Name (Legal Business Name): ALICIA H BUBLITZ MS, RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/28/2021
Last Update Date: 02/06/2025
Certification Date: 02/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

328 W SAINT GEORGES AVE
LINDEN NJ
07036-5638
US

IV. Provider business mailing address

22 EAST AVE
ATLANTIC HIGHLANDS NJ
07716-1664
US

V. Phone/Fax

Practice location:
  • Phone: 908-925-2273
  • Fax:
Mailing address:
  • Phone: 303-641-2208
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number1098927
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: