Provider Demographics
NPI:1407390941
Name:GREAVES, SARI (RDN)
Entity Type:Individual
Prefix:
First Name:SARI
Middle Name:
Last Name:GREAVES
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:192 SUMMERHILL RD
Mailing Address - Street 2:SUITE #201
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-4950
Mailing Address - Country:US
Mailing Address - Phone:732-210-9581
Mailing Address - Fax:
Practice Address - Street 1:192 SUMMERHILL RD
Practice Address - Street 2:SUITE #201
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-4950
Practice Address - Country:US
Practice Address - Phone:732-210-9581
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-16
Last Update Date:2016-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
893737133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered