MEDICARE: MRS. AMY MARIE RAY RD, 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
1	133V00000X	Registered Dietitian	997912	PA

General Provider Information

NPI Number	:	1942610852
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. AMY MARIE RAY RD, RDN

Provider Business Mailing Address
First Line	:	142 ASCOT DR
Second Line	:
City	:	MOUNT ROYAL
State	:	NJ
Zip	:	08061-1118
Country	:	US
Telephone Number	:	610-733-5199
Fax Number	:

Provider Business Practice Location Address
First Line	:	142 ASCOT DR
Second Line	:
City	:	MOUNT ROYAL
State	:	NJ
Zip	:	08061-1118
Country	:	US
Telephone Number	:	610-733-5199
Fax Number	:

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

Provider Enumeration Date	:	04/30/2014
Last Update Date	:	01/02/2023

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