Lifestyle Nutrition

Primary specialty

Nutrition Education NutritionistTaxonomy code 133NN1002X

Legal business name

LIFESTYLE NUTRITION

Practice address

42 Oak St
Lincoln Park, NJ 07035-2434

Phone

(845) 379-4616

NPI assigned

Jun 27, 2018

Organization subpart

No

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

Authorized official

Name

Miss Jaclyn A Jacobsen, M.S.NPI 1912496142

Title

Nutritionist/Owner

Phone

(845) 379-4616

Specialties & licenses 1

Addresses

Practitioners 1

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

• Jaclyn Ann Jacobsen, M.S.

  • Nutrition Education Nutritionist
  • Fair Lawn, NJ
  • NPI 1912496142

  Nutrition, Education

  NPD Authorized official

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

{
    "created_epoch": "1530057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530057600000",
    "number": "1770078107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 OAK ST",
            "city": "LINCOLN PARK",
            "state": "NJ",
            "postal_code": "070352434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 OAK ST",
            "city": "LINCOLN PARK",
            "state": "NJ",
            "postal_code": "070352434",
            "telephone_number": "845-379-4616"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFESTYLE NUTRITION",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-27",
        "last_updated": "2018-06-27",
        "status": "A",
        "authorized_official_last_name": "JACOBSEN",
        "authorized_official_first_name": "JACLYN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "NUTRITIONIST/OWNER",
        "authorized_official_telephone_number": "845-379-4616",
        "authorized_official_name_prefix": "Miss",
        "authorized_official_credential": "M.S."
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Anna Marie Kotsen, MARRIAGE AND FAMILY
• Daniel Kritzer, OPTICIAN
• Julie Ann Kulinski, D.P.T.
• Theresa Cecylija Leszczynski
• Chuen Sing Leung, LMT
• Lincoln Commons Dental Assoc, PA
• Lincoln Park Board of Education
• Lincoln Park Care Center LLC
• Lincoln Park Health Department
• Lincoln Park Hospice

• Nutrition Education Nutritionist in Lincoln Park, NJ
• Providers in Lincoln Park, NJ by specialty
• Nutrition Education Nutritionist in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2018; 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.