NPIMap

Organization Active NPI

Amd Life Sciences LLC

  • Registered Dietitian
  • Princeton, NJ
National Provider Identifier
1447967765
Registry record updated Dec 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
AMD LIFE SCIENCES LLC
Practice address
475 Wall St
Princeton, NJ 08540-1509
Phone
(908) 904-6790
NPI assigned
Nov 7, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 15, 2023

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

Authorized official

Name
Dr. Anju Dang, PHD, RDNNPI 1194448803
Title
Managing Member
Phone
(908) 904-6790

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 133V00000X Primary
Obesity and Weight Management Nutrition Registered DietitianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 133VN1201X

Addresses

Primary practice location

475 Wall St
Princeton, NJ 08540-1509

Mailing address

475 Wall St
Princeton, NJ 08540-1509
Phone (908) 904-6790

Other names 1

  • Princeton Nutrition Therapy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240202002807 NJ Part B Supplier - Clinic/Group Practice 8426491721 Receives reassigned benefits from 1 practitioner
Practice locations: Princeton, NJ

National Provider Directory

National Provider Directory

Locations

475 Wall St
Princeton, NJ 08540
Phone (609) 910-1715

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1667779200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702598400000",
    "number": "1447967765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "475 WALL ST",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085401509",
            "telephone_number": "908-904-6790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "475 WALL ST",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085401509",
            "telephone_number": "908-904-6790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AMD LIFE SCIENCES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-07",
        "last_updated": "2023-12-15",
        "certification_date": "2023-12-15",
        "status": "A",
        "authorized_official_last_name": "DANG",
        "authorized_official_first_name": "ANJU",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "908-904-6790",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHD, RDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "133VN1201X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Dietitian, Registered, Nutrition, Obesity and Weight Management",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Princeton Nutrition Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Princeton Nutrition Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Princeton, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.