Nicholas Mazza
Individual provider Active NPI Registered Dietitian · Pitman, NJ
NPI 1295501344 · NPPES record last updated Nov 29, 2023
Key facts
- NPI
- 1295501344
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 86145599 (NJ)
- Practice address
- 148 S Broadway
Pitman, NJ 08071-2232 - Phone
- (856) 889-1304
- NPI assigned
- Nov 29, 2023
- Sex
- Male
- 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 |
|---|---|---|---|
| 86145599 | NJ | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bradley Management LLC | Dietitian, Registered | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 86145599 | NJ | Yes |
Addresses
Primary practice location
148 S Broadway
Pitman, NJ 08071-2232
Mailing address
148 S Broadway
Pitman, NJ 08071-2232
Other providers in Pitman, NJ
- Richard J. Macfeeters
- Helene Maggioncalda
- Marissa Mansueto
- Kati Mason
- Danielle Matteo
- Cristina Elizabeth Mazzeo
- Constance Dove Meeks
- Mending Hearts Wellness Center, LLC
- Mid-Atlantic Mental Health & Wellness Services
- Dean Michael Millard
All providers in Pitman, 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 Nov 29, 2023. 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.