Active NPI
Stephanie Ingram Song, MS, RD, CDE
- Registered Dietitian
- Saddle Brook, NJ
National Provider Identifier
1396889705
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 5305
- Practice address
- 337 Market St
Suite 1
Saddle Brook, NJ 07663-5313 - Phone
- (201) 368-3800
- Fax
- (201) 368-9787
- NPI assigned
- Feb 18, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 5305 | NY | Primary |
Addresses
Primary practice location
337 Market St
Suite 1
Saddle Brook, NJ 07663-5313
Mailing address
337 Market St
Suite 1
Saddle Brook, NJ 07663-5313
Phone (201) 368-3800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5305 | NY | MD | Registered Dietitian |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1171756800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1396889705",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "337 MARKET ST",
"address_2": "SUITE 1",
"city": "SADDLE BROOK",
"state": "NJ",
"postal_code": "076635313",
"telephone_number": "201-368-3800",
"fax_number": "201-368-9787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "337 MARKET ST",
"address_2": "SUITE 1",
"city": "SADDLE BROOK",
"state": "NJ",
"postal_code": "076635313",
"telephone_number": "201-368-3800",
"fax_number": "201-368-9787"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SONG",
"first_name": "STEPHANIE",
"middle_name": "INGRAM",
"name_prefix": "Mrs.",
"credential": "MS, RD, CDE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-02-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "5305",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saddle Brook, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.