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General NPI Number Information
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NPI Number | 1245798149
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Entity Type | Organization
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Legal Business Name | SHIROM SPA & WELLNESS LLC
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Dates
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Enumeration Date | 03/09/2019
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Last Update Date | 03/09/2019
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Provider Practice Location Address
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Address Line | 2025 OLD TRENTON RD STE 10
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City | WEST WINDSOR
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State | NJ
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Zip | 08550-2412
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Country | US
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Telephone | 609-301-8664
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Fax |
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Provider Business Mailing Address
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Address Line | 2025 OLD TRENTON RD STE 10
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City | WEST WINDSOR
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State | NJ
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Zip | 08550-2412
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Country | US
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Telephone | 609-301-8664
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | SUMBUL RIZVI
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Credential | CE
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Telephone | 609-301-8664
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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