Healthcare Provider Details

I. General information

NPI: 1689545253
Provider Name (Legal Business Name): URSZULA GRYGLAK MS, RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/16/2025
Last Update Date: 09/16/2025
Certification Date: 09/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 N WOOD AVE STE 201
LINDEN NJ
07036-4173
US

IV. Provider business mailing address

8 HILLCREST AVE
BUTLER NJ
07405-1602
US

V. Phone/Fax

Practice location:
  • Phone: 908-925-3300
  • Fax:
Mailing address:
  • Phone: 201-574-3437
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86374567
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: