Provider Demographics
NPI:1073867248
Name:SCHWARTZER, MARY ELIZABETH (RD)
Entity Type:Individual
Prefix:
First Name:MARY ELIZABETH
Middle Name:
Last Name:SCHWARTZER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 VERONICA AVE
Mailing Address - Street 2:SUITE 204
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-5002
Mailing Address - Country:US
Mailing Address - Phone:732-828-0002
Mailing Address - Fax:732-828-0153
Practice Address - Street 1:75 VERONICA AVE
Practice Address - Street 2:SUITE 204
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-5002
Practice Address - Country:US
Practice Address - Phone:732-828-0002
Practice Address - Fax:732-828-0153
Is Sole Proprietor?:No
Enumeration Date:2012-11-09
Last Update Date:2012-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ01043636133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ01043636OtherREGISTERED DIETITIAN