Provider Demographics
NPI:1083242986
Name:EGAN, BRIANA (RD, CSG, LDN)
Entity Type:Individual
Prefix:MS
First Name:BRIANA
Middle Name:
Last Name:EGAN
Suffix:
Gender:F
Credentials:RD, CSG, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:81 BERGEN DR
Mailing Address - Street 2:
Mailing Address - City:WEST MILFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07480-1149
Mailing Address - Country:US
Mailing Address - Phone:973-610-8548
Mailing Address - Fax:
Practice Address - Street 1:81 BERGEN DR
Practice Address - Street 2:
Practice Address - City:WEST MILFORD
Practice Address - State:NJ
Practice Address - Zip Code:07480-1149
Practice Address - Country:US
Practice Address - Phone:973-610-8548
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-28
Last Update Date:2023-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA1002713133VN1101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1101XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Gerontological