Healthcare Provider Details

I. General information

NPI: 1437013489
Provider Name (Legal Business Name): AISHWARYA JAISHANKAR RDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/15/2025
Last Update Date: 12/15/2025
Certification Date: 12/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

52 ROSEMARY WAY
MOUNT LAUREL NJ
08054-9766
US

IV. Provider business mailing address

3724 JEFFERSON ST STE 104
AUSTIN TX
78731-6204
US

V. Phone/Fax

Practice location:
  • Phone: 732-857-1794
  • Fax:
Mailing address:
  • Phone: 512-693-7045
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86088912
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: