Provider Demographics
NPI:1366508491
Name:HARRIS-PINCUS, LAUREN (MS, RD)
Entity Type:Individual
Prefix:
First Name:LAUREN
Middle Name:
Last Name:HARRIS-PINCUS
Suffix:
Gender:F
Credentials:MS, 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 GREEN VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:GREEN BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:08812-2036
Mailing Address - Country:US
Mailing Address - Phone:732-748-9680
Mailing Address - Fax:732-748-0236
Practice Address - Street 1:24 GREEN VALLEY DR
Practice Address - Street 2:
Practice Address - City:GREEN BROOK
Practice Address - State:NJ
Practice Address - Zip Code:08812-2036
Practice Address - Country:US
Practice Address - Phone:732-748-9680
Practice Address - Fax:732-748-0236
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
808970133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered