MEDICARE: ASHLEY COX 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	86060201

General Provider Information

NPI Number	:	1568180131
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY COX RD

Provider Business Mailing Address
First Line	:	110 1ST ST APT 28O
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07302-8993
Country	:	US
Telephone Number	:	413-575-1449
Fax Number	:

Provider Business Practice Location Address
First Line	:	110 1ST ST APT 28O
Second Line	:
City	:	JERSEY CITY
State	:	NJ
Zip	:	07302-8993
Country	:	US
Telephone Number	:	413-575-1449
Fax Number	:

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

Provider Enumeration Date	:	08/18/2022
Last Update Date	:	05/18/2026

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