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NPI Code Detail

MEDICARE: MARISSA LAURENE THORSEN RDN

MEDICARE:   MARISSA LAURENE THORSEN  RDN
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
1133V00000XRegistered Dietitian

General Provider Information

NPI Number : 1346124401
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARISSA LAURENE THORSEN RDN
Provider Business Mailing Address
First Line : 9 GENERAL MORGAN LN
Second Line :
City : GLEN GARDNER
State : NJ
Zip : 08826-3161
Country : US
Telephone Number : 908-839-2492
Fax Number :
Provider Business Practice Location Address
First Line : 9 GENERAL MORGAN LN
Second Line :
City : GLEN GARDNER
State : NJ
Zip : 08826-3161
Country : US
Telephone Number : 908-839-2492
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2025
Last Update Date : 08/02/2025

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Directions to “ MARISSA LAURENE THORSEN RDN” Practice Location

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