MEDICARE: KARI LOUISE EWING RD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	812305	NJ

General Provider Information

NPI Number	:	1164391777
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARI LOUISE EWING RD

Provider Business Mailing Address
First Line	:	140 HEPBURN RD APT 3N
Second Line	:
City	:	CLIFTON
State	:	NJ
Zip	:	07012-2217
Country	:	US
Telephone Number	:	973-204-1904
Fax Number	:

Provider Business Practice Location Address
First Line	:	140 HEPBURN RD APT 3N
Second Line	:
City	:	CLIFTON
State	:	NJ
Zip	:	07012-2217
Country	:	US
Telephone Number	:	973-204-1904
Fax Number	:	973-204-1904

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/03/2025
Last Update Date	:	11/03/2025

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