Provider Demographics
NPI:1073814042
Name:BACK TO BASICS NUTRITION COUNSELING, LLC
Entity Type:Organization
Organization Name:BACK TO BASICS NUTRITION COUNSELING, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEGAN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARCHATERRE
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:973-744-7495
Mailing Address - Street 1:90 E HALSEY RD STE 321
Mailing Address - Street 2:
Mailing Address - City:PARSIPPANY
Mailing Address - State:NJ
Mailing Address - Zip Code:07054-3713
Mailing Address - Country:US
Mailing Address - Phone:973-744-7495
Mailing Address - Fax:973-771-3852
Practice Address - Street 1:90 E HALSEY RD # 321
Practice Address - Street 2:
Practice Address - City:PARSIPPANY
Practice Address - State:NJ
Practice Address - Zip Code:07054-3713
Practice Address - Country:US
Practice Address - Phone:973-744-7495
Practice Address - Fax:973-695-1655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-11-08
Last Update Date:2024-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ193521OtherMEDICARE
NJ9176666OtherAETNA
NJ3159504OtherUNITED HEALTHCARE
NJ193521OtherMEDICARE