NPIMap

Organization Active NPI

Professional Advantage Nutrition and Fitness, LLC

  • Registered Dietitian
  • East Rutherford, NJ
National Provider Identifier
1134480528
Registry record updated Sep 27, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
942839 Issued in NJ
Legal business name
PROFESSIONAL ADVANTAGE NUTRITION AND FITNESS, LLC
Practice address
341 Railroad Ave
East Rutherford, NJ 07073-1717
Phone
(201) 446-3736
Fax
(201) 438-7174
NPI assigned
Jun 3, 2012
Last updated
Sep 27, 2013By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2013

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Dina Ford, RDNNPI 1851659775
Title
President
Phone
(201) 446-3736

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X 942839 NJ Primary

Addresses

Primary practice location

341 Railroad Ave
East Rutherford, NJ 07073-1717

Mailing address

201 Union Ave
Wood Ridge, NJ 07075-1906
Phone (201) 446-3736

National Provider Directory

National Provider Directory

Locations

341 Railroad Ave
East Rutherford, NJ 07073
Phone (201) 438-7189

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1338681600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1380240000000",
    "number": "1134480528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "201 UNION AVE",
            "city": "WOOD RIDGE",
            "state": "NJ",
            "postal_code": "070751906",
            "telephone_number": "201-446-3736",
            "fax_number": "201-438-7174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "341 RAILROAD AVE",
            "city": "EAST RUTHERFORD",
            "state": "NJ",
            "postal_code": "070731717",
            "telephone_number": "201-446-3736",
            "fax_number": "201-438-7174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL ADVANTAGE NUTRITION AND FITNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-03",
        "last_updated": "2013-09-27",
        "status": "A",
        "authorized_official_last_name": "FORD",
        "authorized_official_first_name": "DINA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "201-446-3736",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "NJ",
            "license": "942839",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Rutherford, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.