Provider Demographics
NPI:1467591727
Name:MYERS, MARY W (MS,RD)
Entity Type:Individual
Prefix:MS
First Name:MARY
Middle Name:W
Last Name:MYERS
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 1:90 PRINCESS ANNE DR
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-3040
Mailing Address - Country:US
Mailing Address - Phone:732-625-1513
Mailing Address - Fax:
Practice Address - Street 1:90 PRINCESS ANNE DR
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-3040
Practice Address - Country:US
Practice Address - Phone:732-625-1513
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
Not Answered133V00000XDietary & Nutritional Service ProvidersDietitian, Registered