Comfort N Ekunno-Tabansi, REGISTERED DIETITIAN

Primary specialty

Metabolic Nutrition Registered DietitianTaxonomy code 133VN1006X

License

927499 Issued in IL

Practice address

170 Norwood St
Newark, NJ 07106-2627

Phone

(201) 491-9972

Fax

(973) 324-2218

NPI assigned

Apr 4, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Gocopetra Care Consultant LLC

  • Metabolic Nutrition Registered Dietitian
  • Newark, NJ
  • NPI 1124122353

  Nutrition, Metabolic

  NPD (past) Authorized official

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

{
    "created_epoch": "1175644800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195516800000",
    "number": "1306968938",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "540 HILLSIDE TER",
            "city": "WEST ORANGE",
            "state": "NJ",
            "postal_code": "070524306",
            "telephone_number": "201-491-9972",
            "fax_number": "973-324-2218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "170 NORWOOD ST",
            "city": "NEWARK",
            "state": "NJ",
            "postal_code": "071062627",
            "telephone_number": "201-491-9972",
            "fax_number": "973-324-2218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EKUNNO-TABANSI",
        "first_name": "COMFORT",
        "middle_name": "N",
        "credential": "REGISTERED DIETITIAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-04",
        "last_updated": "2007-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1006X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Metabolic",
            "state": "IL",
            "license": "927499",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RENDERING NUMBER",
            "identifier": "097992U0Y",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Frank Ehrlich, M.D.
• Tzeidel Brown Eichenberg, MD
• Mark H Einstein, MD
• Olufunmilayo Temitope Ekibolaji
• Zareh Ekmekjian, MD
• El Shaddai Pharmacy
• Hind El-Hammali, DMD
• Elderly Mind and Spirts
• Mohamed H Eldesouki, MD
• Nada-Lina Eldin

• Metabolic Nutrition Registered Dietitian in Newark, NJ
• Providers in Newark, NJ by specialty
• Metabolic Nutrition Registered Dietitian in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2007; 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.