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General NPI Number Information
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NPI Number | 1215607023
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Entity Type | Individual
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Provider Name | ANNAMARIA LOULOUDIS RD
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Gender | Female
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Dates
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Enumeration Date | 09/14/2021
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Last Update Date | 09/14/2021
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Provider Practice Location Address
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Address Line | 720 MONROE ST STE E518
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City | HOBOKEN
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State | NJ
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Zip | 07030-6375
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Country | US
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Telephone | 917-647-1665
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Fax |
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Provider Business Mailing Address
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Address Line | 1 FOREST AVE
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City | OLD TAPPAN
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State | NJ
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Zip | 07675-7108
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Country | US
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Telephone | 201-741-0011
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Fax |
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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 | 133VN1004X
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Taxonomy Name | Pediatric Nutrition Registered Dietitian
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License Number |
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License Number State |
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