Provider Demographics
NPI:1457825622
Name:SHORE NUTRITION ASSOCIATES
Entity Type:Organization
Organization Name:SHORE NUTRITION ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:R
Authorized Official - Last Name:MONTGOMERY
Authorized Official - Suffix:IV
Authorized Official - Credentials:RD
Authorized Official - Phone:732-539-3584
Mailing Address - Street 1:1201 SPRINGWOOD AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:ASBURY PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07712-6796
Mailing Address - Country:US
Mailing Address - Phone:732-539-3584
Mailing Address - Fax:
Practice Address - Street 1:1201 SPRINGWOOD AVE STE 104
Practice Address - Street 2:
Practice Address - City:ASBURY PARK
Practice Address - State:NJ
Practice Address - Zip Code:07712-6796
Practice Address - Country:US
Practice Address - Phone:732-539-3584
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-21
Last Update Date:2021-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133N00000XDietary & Nutritional Service ProvidersNutritionistGroup - Single Specialty