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General NPI Number Information
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NPI Number | 1134941099
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Entity Type | Organization
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Legal Business Name | THS NUTRITIONAL NAVIGATORS
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Dates
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Enumeration Date | 10/30/2024
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Last Update Date | 10/30/2024
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Provider Practice Location Address
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Address Line | 123 HIGHLAND AVE STE G2
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City | GLEN RIDGE
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State | NJ
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Zip | 07028-1522
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Country | US
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Telephone | 862-346-5380
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Fax | 908-652-9230
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Provider Business Mailing Address
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Address Line | 123 HIGHLAND AVE STE G2
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City | GLEN RIDGE
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State | NJ
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Zip | 07028-1522
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Country | US
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Telephone | 862-346-5380
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Fax | 908-652-9230
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Authorized Official
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Title or Position | DIRECTOR
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Name | SIMEON MERTYL
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Credential |
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Telephone | 862-346-5380
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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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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