Provider Demographics
NPI:1477630861
Name:SPITZBERG, ERIN T (RD)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:T
Last Name:SPITZBERG
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 KENILWORTH RD
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-5209
Mailing Address - Country:US
Mailing Address - Phone:201-615-7585
Mailing Address - Fax:973-765-9366
Practice Address - Street 1:7 COLUMBIA TPKE
Practice Address - Street 2:
Practice Address - City:FLORHAM PARK
Practice Address - State:NJ
Practice Address - Zip Code:07932-2201
Practice Address - Country:US
Practice Address - Phone:973-765-9355
Practice Address - Fax:973-765-9366
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ831861133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP3417634OtherOXFORD
NJ2850045000OtherAMERIHEALTH
NJ3685013OtherAETNA
NJ0600289OtherCIGNA