Healthcare Provider Details

I. General information

NPI: 1295946887
Provider Name (Legal Business Name): NUTRITION WORKS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 06/02/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

32 DEHART ST
MORRISTOWN NJ
07960-5210
US

IV. Provider business mailing address

32 DEHART STREET
MORRISTOWN NJ
07960-1627
US

V. Phone/Fax

Practice location:
  • Phone: 973-610-4856
  • Fax: 973-839-0084
Mailing address:
  • Phone: 973-610-4856
  • Fax: 973-839-0084

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number706929
License Number StateNJ

VIII. Authorized Official

Name: JOHANNA BURANI
Title or Position: OWNER
Credential: MS,RD,CDE
Phone: 973-610-4856