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General NPI Number Information
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NPI Number | 1699223750
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Entity Type | Organization
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Legal Business Name | MEIRA WALDMAN RD LLC
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Dates
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Enumeration Date | 09/19/2016
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Last Update Date | 03/27/2025
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Provider Practice Location Address
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Address Line | 205 WYNATT STREET
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City | LAKEWOOD
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State | NJ
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Zip | 08701-4839
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Country | US
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Telephone | 732-534-0610
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Fax | 848-373-9499
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Provider Business Mailing Address
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Address Line | 205 WYNATT STREET
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City | LAKEWOOD
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State | NJ
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Zip | 08701-4839
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Country | US
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Telephone | 732-534-0610
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Fax | 848-373-9499
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Authorized Official
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Title or Position | KP OWNER
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Name | MRS. MEIRA RAIZEL WALDMAN
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Credential | RD
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Telephone | 732-534-0610
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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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Taxonomy #2
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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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