MEDICARE: SARAH DADE AADP, IAHC, INHC

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	133NN1002X	Nutrition Education Nutritionist	132053303	NJ

General Provider Information

NPI Number	:	1922461821
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SARAH DADE AADP, IAHC, INHC

Provider Business Mailing Address
First Line	:	135 38TH ST
Second Line	:	SUITE 605
City	:	UNION CITY
State	:	NJ
Zip	:	07087-6085
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	135 38TH ST
Second Line	:	SUITE 605
City	:	UNION CITY
State	:	NJ
Zip	:	07087-6085
Country	:	US
Telephone Number	:	908-887-0090
Fax Number	:

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

Provider Enumeration Date	:	03/30/2016
Last Update Date	:	03/30/2016

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