Healthcare Provider Details

I. General information

NPI: 1598107328
Provider Name (Legal Business Name): EVERYDAY NUTRITION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/22/2013
Last Update Date: 07/22/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 MARLTON DR
WAYNE NJ
07470-5331
US

IV. Provider business mailing address

42 MARLTON DR
WAYNE NJ
07470-5331
US

V. Phone/Fax

Practice location:
  • Phone: 973-696-7526
  • Fax: 973-633-5401
Mailing address:
  • Phone: 973-696-7526
  • Fax: 973-633-5401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133VN1005X
TaxonomyRenal Nutrition Registered Dietitian
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code133VN1004X
TaxonomyPediatric Nutrition Registered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: MS. LISA A APA
Title or Position: REGISTERED DIETITIAN
Credential: R.D.
Phone: 973-696-7526