Provider Demographics
NPI:1356650667
Name:MONZO, AMY (RD)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:
Last Name:MONZO
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:GROBE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:612 RUTHERFORD AVE
Mailing Address - Street 2:
Mailing Address - City:LYNDHURST
Mailing Address - State:NJ
Mailing Address - Zip Code:07071
Mailing Address - Country:US
Mailing Address - Phone:201-460-0063
Mailing Address - Fax:201-460-1684
Practice Address - Street 1:612 RUTHERFORD AVE
Practice Address - Street 2:
Practice Address - City:LYNDHURST
Practice Address - State:NJ
Practice Address - Zip Code:07071
Practice Address - Country:US
Practice Address - Phone:201-460-0063
Practice Address - Fax:201-460-1684
Is Sole Proprietor?:No
Enumeration Date:2010-10-04
Last Update Date:2020-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ932870133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered