Provider Demographics
NPI:1003979568
Name:NEWSWANGER, ANN C (RD CDE)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:C
Last Name:NEWSWANGER
Suffix:
Gender:F
Credentials:RD CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 CLAREMONT PLACE
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-2213
Mailing Address - Country:US
Mailing Address - Phone:908-272-7586
Mailing Address - Fax:
Practice Address - Street 1:114 CLAREMONT PLACE
Practice Address - Street 2:
Practice Address - City:CRANFORD
Practice Address - State:NJ
Practice Address - Zip Code:07016-2213
Practice Address - Country:US
Practice Address - Phone:908-272-7586
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
691219133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered