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General NPI Number Information
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NPI Number | 1003612011
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Entity Type | Organization
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Legal Business Name | SLENDERFY
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Dates
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Enumeration Date | 02/20/2025
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Last Update Date | 02/20/2025
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Provider Practice Location Address
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Address Line | 555 MADISON AVE
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City | LAKEWOOD
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State | NJ
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Zip | 08701-3255
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Country | US
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Telephone | 732-664-4624
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Fax |
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Provider Business Mailing Address
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Address Line | 1 HUNTER DR
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City | LAKEWOOD
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State | NJ
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Zip | 08701-4755
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Country | US
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Telephone | 732-664-4624
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Fax |
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Authorized Official
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Title or Position | MEDICAL DIRECTOR
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Name | DR. DANIEL SELIG
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Credential | MD
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Telephone | 732-664-4624
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RA0000X
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Taxonomy Name | Adolescent Medicine (Internal Medicine) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 133VN1201X
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Taxonomy Name | Obesity and Weight Management Nutrition Registered Dietitian
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License Number |
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License Number State |
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