Provider Demographics
NPI:1609028802
Name:SOMERSET NUTRICARE LLC
Entity Type:Organization
Organization Name:SOMERSET NUTRICARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:KANIKA
Authorized Official - Middle Name:A
Authorized Official - Last Name:GANDHI
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:908-431-0900
Mailing Address - Street 1:83 HILLS DR
Mailing Address - Street 2:
Mailing Address - City:BELLE MEAD
Mailing Address - State:NJ
Mailing Address - Zip Code:08502-4226
Mailing Address - Country:US
Mailing Address - Phone:908-431-0900
Mailing Address - Fax:
Practice Address - Street 1:1323 ROUTE 27
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873
Practice Address - Country:US
Practice Address - Phone:908-431-0900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2008-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ805907133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty