Provider Demographics
NPI:1588224182
Name:AMSTER, DAVID
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:AMSTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:140 AMSTERDAM AVE
Mailing Address - Street 2:
Mailing Address - City:PASSAIC
Mailing Address - State:NJ
Mailing Address - Zip Code:07055-2440
Mailing Address - Country:US
Mailing Address - Phone:646-379-8301
Mailing Address - Fax:
Practice Address - Street 1:336 W PASSAIC ST
Practice Address - Street 2:
Practice Address - City:ROCHELLE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07662-3027
Practice Address - Country:US
Practice Address - Phone:646-379-8301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-17
Last Update Date:2019-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist