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General NPI Number Information
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NPI Number | 1033503057
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Entity Type | Individual
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Provider Name | SARAH STITES RD
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Gender | Female
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Dates
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Enumeration Date | 03/27/2015
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Last Update Date | 04/16/2015
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Provider Practice Location Address
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Address Line | 166 LYONS AVE
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City | NEWARK
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State | NJ
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Zip | 07112-2016
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Country | US
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Telephone | 973-926-2884
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Fax | 973-926-2978
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Provider Business Mailing Address
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Address Line | 34 SHERBROOKE DR
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City | FLORHAM PARK
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State | NJ
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Zip | 07932-2816
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Country | US
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Telephone | 973-410-0751
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Fax | 973-926-2978
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 727622
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License Number State | NJ
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