Marisa Juliana Mongioi, RDN

Individual provider Active NPI Registered Dietitian · Farmingdale, NJ

NPI 1043889280 · NPPES record last updated Jul 29, 2021

Key facts

NPI
1043889280
Entity type
Individual (NPI type 1)
Primary specialty
Registered Dietitian 133V00000X
License
86149910 (NY)
Practice address
301 Cranberry Rd
Farmingdale, NJ 07727-3510
Phone
(732) 259-3369
NPI assigned
Jun 22, 2021
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
86149910NYMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Fay Nutrition Dietitian, Registered Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 86149910 NY Yes

Addresses

Primary practice location

301 Cranberry Rd
Farmingdale, NJ 07727-3510

Mailing address

301 Cranberry Rd
Farmingdale, NJ 07727-3510
Phone (732) 259-3369

Other providers in Farmingdale, NJ

All providers in Farmingdale, NJ · Registered Dietitian in New Jersey

Sources for this page

Verify at the official NPI Registry.