Provider Demographics
NPI:1609254036
Name:LEPICARD, NANI (RD)
Entity Type:Individual
Prefix:
First Name:NANI
Middle Name:
Last Name:LEPICARD
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 1:370 CLAREMONT AVE APT A-2
Mailing Address - Street 2:
Mailing Address - City:MONTCLAIR
Mailing Address - State:NJ
Mailing Address - Zip Code:07042-1802
Mailing Address - Country:US
Mailing Address - Phone:732-283-1900
Mailing Address - Fax:732-898-3951
Practice Address - Street 1:20 THISTLE LN
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059-5564
Practice Address - Country:US
Practice Address - Phone:732-283-1900
Practice Address - Fax:732-898-3951
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-18
Last Update Date:2015-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY917434133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered