Provider Demographics
NPI:1114968740
Name:ARMSTRONG, ANITA (RD)
Entity Type:Individual
Prefix:
First Name:ANITA
Middle Name:
Last Name:ARMSTRONG
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 1:48 MOHAWK AVE
Mailing Address - Street 2:
Mailing Address - City:ROCKAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07866-1827
Mailing Address - Country:US
Mailing Address - Phone:973-983-2525
Mailing Address - Fax:973-983-2525
Practice Address - Street 1:48 MOHAWK AVE
Practice Address - Street 2:
Practice Address - City:ROCKAWAY
Practice Address - State:NJ
Practice Address - Zip Code:07866-1827
Practice Address - Country:US
Practice Address - Phone:973-983-2525
Practice Address - Fax:973-983-2525
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ811953133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ054563Medicare ID - Type Unspecified