Sharon R. Wieder, RD

Individual provider Active NPI Pediatric Nutrition Registered Dietitian · Bogota, NJ

NPI 1992205447 · NPPES record last updated Oct 15, 2018

Key facts

NPI
1992205447
Entity type
Individual (NPI type 1)
Primary specialty
Pediatric Nutrition Registered Dietitian 133VN1004X
Practice address
100 E Main St
Bogota, NJ 07603-1310
Phone
(201) 314-8545
NPI assigned
Feb 20, 2018
Sex
Female
Sole proprietor
Yes

Organizations & group practices 3

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Practice roles

OrganizationSpecialtyStatusNew patients
Sharon Wieder Nutrition LLC Nutrition, Pediatric Current Accepting new patients
Nourish, Inc. Past Accepting new patients
Boro Park Nutrition, LLC Past Accepting new patients

Locations

100 E Main St
Bogota, NJ 07603
Phone (201) 314-8545

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nutrition Registered Dietitian 133VN1004X Yes

Addresses

Primary practice location

100 E Main St
Bogota, NJ 07603-1310

Mailing address

PO Box 3382
Teaneck, NJ 07666
Phone (201) 314-8545

Other providers in Bogota, NJ

All providers in Bogota, NJ · Pediatric Nutrition Registered Dietitian in New Jersey

Sources for this page

Verify at the official NPI Registry.