Provider Demographics
NPI:1093126898
Name:KATIE DAY NUTRITION LLC
Entity Type:Organization
Organization Name:KATIE DAY NUTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:
Authorized Official - Last Name:DAY
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD, CDN, CNSC
Authorized Official - Phone:201-390-3861
Mailing Address - Street 1:542 4TH AVE APT 1B
Mailing Address - Street 2:
Mailing Address - City:WESTWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-2146
Mailing Address - Country:US
Mailing Address - Phone:201-390-3861
Mailing Address - Fax:201-383-0097
Practice Address - Street 1:297 KINDERKAMACK RD STE 202
Practice Address - Street 2:
Practice Address - City:ORADELL
Practice Address - State:NJ
Practice Address - Zip Code:07649-1535
Practice Address - Country:US
Practice Address - Phone:201-390-3861
Practice Address - Fax:201-383-0097
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-14
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1019678133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty