Healthcare Provider Details

I. General information

NPI: 1871929109
Provider Name (Legal Business Name): JANET S. KOPCHINSKI R.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MS. JANET S. SCHAUBEN

II. Dates (important events)

Enumeration Date: 09/18/2013
Last Update Date: 09/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 WASHINGTON STREET SUITE 3 BE WELL MORRISTOWN
MORRISTOWN NJ
07960
US

IV. Provider business mailing address

7 WASHINGTON STREET SUITE 3 BE WELL MORRISTOWN
MORRISTOWN NJ
07960
US

V. Phone/Fax

Practice location:
  • Phone: 973-975-0280
  • Fax:
Mailing address:
  • Phone: 973-975-0280
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License Number48005753
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: