Jeanette Kimszal, R.D.
Individual provider Active NPI Registered Dietitian · South Amboy, NJ
NPI 1013467489 · NPPES record last updated Oct 10, 2016
Key facts
- NPI
- 1013467489
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 86040094 (NJ)
- Practice address
- 3 Vandelft Dr
Apartment 16
South Amboy, NJ 08879-2356 - Phone
- (908) 230-1280
- NPI assigned
- Oct 10, 2016
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 86040094 | NJ | MD | Registered Dietitian |
Practice roles (1 of 3)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Networks
- TX HMO
- TX HMO D-SNP
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86040094 | NJ | Yes |
Addresses
Primary practice location
3 Vandelft Dr
Apartment 16
South Amboy, NJ 08879-2356
Mailing address
3 Vandelft Dr
Apartment 16
South Amboy, NJ 08879-2356
Phone (908) 230-1280
Other providers in South Amboy, NJ
- Derek W Jones
- Fadi Kano
- Shahirose Kapadia
- Arthur Karwowski
- Maria Khan
- Penelope A King
- Ira M Klemons
- Lina Klossek
- KM Medical Supply
- Kyle A Knoell
All providers in South Amboy, NJ · Registered Dietitian in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.