Provider Demographics
NPI:1114062957
Name:WEISBERGER, MICHELE (RD)
Entity Type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:
Last Name:WEISBERGER
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 1:24 RUSKIN CT
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2631
Mailing Address - Country:US
Mailing Address - Phone:973-389-0920
Mailing Address - Fax:973-389-0027
Practice Address - Street 1:557 BROAD ST
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07003-2885
Practice Address - Country:US
Practice Address - Phone:973-680-8300
Practice Address - Fax:973-680-1770
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered