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General NPI Number Information
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NPI Number | 1386963874
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Entity Type | Organization
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Legal Business Name | NEW JERSEY CENTER FOR NUTRITION AND DIETETICS LLC
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Dates
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Enumeration Date | 05/23/2010
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Last Update Date | 09/17/2012
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Provider Practice Location Address
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Address Line | 55 MADISON AVE SUITE 400
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City | MORRISTOWN
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State | NJ
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Zip | 07960-7337
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Country | US
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Telephone | 973-944-0171
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Fax |
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Provider Business Mailing Address
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Address Line | 55 MADISON AVE SUITE 400
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City | MORRISTOWN
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State | NJ
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Zip | 07960-7337
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Country | US
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Telephone | 973-944-0171
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Fax |
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Authorized Official
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Title or Position | REGISTERED DIETITIAN
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Name | MISS MARISA ANN SWEENEY
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Credential | RD
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Telephone | 732-773-0215
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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 | 1034952
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License Number State | NJ
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