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General NPI Number Information
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NPI Number | 1225621675
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Entity Type | Organization
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Legal Business Name | SIMPLY SUSTAINABLE NUTRITION LLC
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Dates
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Enumeration Date | 02/17/2021
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Last Update Date | 03/23/2026
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Provider Practice Location Address
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Address Line | 4 CREAMER DR
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City | SAYREVILLE
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State | NJ
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Zip | 08872-1954
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Country | US
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Telephone | 732-351-4424
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Fax |
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Provider Business Mailing Address
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Address Line | 253 MAIN ST STE 250
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City | MATAWAN
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State | NJ
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Zip | 07747-3222
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Country | US
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Telephone | 908-307-8066
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KERRY CONLON
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Credential | RDN
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Telephone | 908-307-8066
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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 |
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License Number State |
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