Provider Demographics
NPI:1275677312
Name:KRANTZ, SUSAN RUTH (MA , RD, CDE)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:RUTH
Last Name:KRANTZ
Suffix:
Gender:F
Credentials:MA , RD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:334 W OCEAN HEIGHTS AVE
Mailing Address - Street 2:UNIT 114
Mailing Address - City:LINWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08221-1464
Mailing Address - Country:US
Mailing Address - Phone:609-927-1473
Mailing Address - Fax:609-927-0668
Practice Address - Street 1:1201 NEW RD
Practice Address - Street 2:
Practice Address - City:LINWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08221-1150
Practice Address - Country:US
Practice Address - Phone:609-226-8893
Practice Address - Fax:609-927-0668
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-19
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ145299QLLMedicare PIN