Provider Demographics
NPI:1326077298
Name:POTOPOWICZ, MEGHAN K (RD)
Entity Type:Individual
Prefix:
First Name:MEGHAN
Middle Name:K
Last Name:POTOPOWICZ
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 1:50 TWIN FALLS RD
Mailing Address - Street 2:
Mailing Address - City:BERKELEY HEIGHTS
Mailing Address - State:NJ
Mailing Address - Zip Code:07922-2715
Mailing Address - Country:US
Mailing Address - Phone:908-581-7919
Mailing Address - Fax:
Practice Address - Street 1:1129 BLOOMFIELD AVE
Practice Address - Street 2:
Practice Address - City:WEST CALDWELL
Practice Address - State:NJ
Practice Address - Zip Code:07006-7127
Practice Address - Country:US
Practice Address - Phone:973-227-2272
Practice Address - Fax:973-227-2279
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-02
Last Update Date:2009-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered