Customized Performance Foods

Primary specialty

Mail Order PharmacyTaxonomy code 3336M0002X

Legal business name

CUSTOMIZED PERFORMANCE FOODS

Doing business as

Dietary Specialties

Practice address

10 Leslie CT
Whippany, NJ 07981-1635

Phone

(888) 640-2800

Fax

(973) 884-5907

NPI assigned

Dec 5, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Roger Jones

Title

Vice President General Manager

Phone

(973) 884-5837

Specialties & licenses 1

Addresses

Other names 1

• Dietary Specialties Doing business as

Locations

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

{
    "created_epoch": "1165276800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1184782955",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 LESLIE CT",
            "city": "WHIPPANY",
            "state": "NJ",
            "postal_code": "079811635",
            "telephone_number": "888-640-2800",
            "fax_number": "973-884-5907"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 LESLIE CT",
            "city": "WHIPPANY",
            "state": "NJ",
            "postal_code": "079811635",
            "telephone_number": "888-640-2800",
            "fax_number": "973-884-5907"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOMIZED PERFORMANCE FOODS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-05",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "JONES",
        "authorized_official_first_name": "ROGER",
        "authorized_official_title_or_position": "VICE PRESIDENT GENERAL MANAGER",
        "authorized_official_telephone_number": "973-884-5837",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "3336M0002X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Mail Order Pharmacy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Dietary Specialties",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Anisha Chhibber, MS, RD, CNSC, FAND
• Laura Cinque, D.C.
• Christina Cloke, MD
• CMC Adaptive Seating & Homecare, LLC
• Rosa Coppolecchia, DO, MPH
• Mohamed Datoo
• Julia Lynn Davidson, MD, RDN
• Crystal De la Cruz
• Surani Marie De Silva
• Annemieke LMF De Wilde, M.D.

• Mail Order Pharmacy in Whippany, NJ
• Providers in Whippany, NJ by specialty
• Mail Order Pharmacy in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.