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General NPI Number Information
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NPI Number | 1538589353
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Entity Type | Individual
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Provider Name | VANESSA DYE
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Gender | Female
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Dates
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Enumeration Date | 04/19/2014
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Last Update Date | 04/19/2014
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Provider Practice Location Address
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Address Line | 116 SAINT CLAIR AVE
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City | HAMILTON
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State | NJ
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Zip | 08619-1235
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Country | US
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Telephone | 609-672-3827
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Fax |
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Provider Business Mailing Address
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Address Line | 180 ROUTE 130
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City | BORDENTOWN
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State | NJ
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Zip | 08505-2203
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Country | US
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Telephone |
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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 | 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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