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NPI Code Detail

MEDICARE: ERIN LONG RD

MEDICARE: ERIN LONG 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
1133V00000XRegistered Dietitian86156436NJ

General Provider Information

NPI Number : 1407673841
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIN LONG RD
Provider Business Mailing Address
First Line : 10 SAND SPRING RD
Second Line :
City : MORRISTOWN
State : NJ
Zip : 07960-7152
Country : US
Telephone Number : 973-727-8546
Fax Number :
Provider Business Practice Location Address
First Line : 10 SAND SPRING RD
Second Line :
City : MORRISTOWN
State : NJ
Zip : 07960-7152
Country : US
Telephone Number : 973-727-8546
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2024
Last Update Date : 09/25/2024

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