Healthcare Provider Details

I. General information

NPI: 1851187496
Provider Name (Legal Business Name): MARIAH MARSH NUTRITION SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2025
Last Update Date: 04/18/2025
Certification Date: 04/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5 W CHESTNUT AVE
MERCHANTVILLE NJ
08109-2309
US

IV. Provider business mailing address

243 OAK ST
AUDUBON NJ
08106-1553
US

V. Phone/Fax

Practice location:
  • Phone: 484-686-3473
  • Fax: 856-494-1924
Mailing address:
  • Phone: 484-686-3473
  • Fax: 856-494-1924

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MARIAH LARAIO
Title or Position: OWNER
Credential: RD, LDN
Phone: 484-686-3473