Center for Medical Nutrition Therapy LLC
Organization Active NPI Registered Dietitian · Bergenfield, NJ
NPI 1114357019 · NPPES record last updated Jun 3, 2015
Key facts
- NPI
- 1114357019
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Registered Dietitian 133V00000X
- Legal business name
- CENTER FOR MEDICAL NUTRITION THERAPY LLC
- Practice address
- 26 Byrne PL
Bergenfield, NJ 07621-1002 - Phone
- (551) 486-6604
- Fax
- (201) 501-0543
- NPI assigned
- Nov 14, 2013
- Organization subpart
- No
Authorized official
- Name
- Miss Marilyn R. Quintana, R.D.
- Title
- Proprietor
- Phone
- (551) 486-6604
Practitioners 1
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150602000226 | NJ | Part B Supplier - Clinic/Group Practice | 3375864499 |
Receives reassigned benefits from 1 practitioner Practice locations: Jersey City, NJ |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian |
133V00000X | Yes |
Addresses
Primary practice location
26 Byrne PL
Bergenfield, NJ 07621-1002
Mailing address
26 Byrne PL
Bergenfield, NJ 07621-1002
Phone (551) 486-6604
Other providers in Bergenfield, NJ
- Caring Hearts Home Care
- Krista Lacap Carramusa
- Leslie Carter
- Angelica Castillo
- Aricia Centeno-Sosa
- Center for Nephrology & Hypertension
- Seoyoon Chang
- Sara Cherian
- Jojy Cheriyan
- Gregory Chery
All providers in Bergenfield, 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 Jun 3, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.