Provider Demographics
NPI:1609285196
Name:MONGE, MARGARET JANE (RD, CDCES)
Entity Type:Individual
Prefix:
First Name:MARGARET
Middle Name:JANE
Last Name:MONGE
Suffix:
Gender:F
Credentials:RD, CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 STONE HARBOR BLVD
Mailing Address - Street 2:
Mailing Address - City:CAPE MAY COURT HOUSE
Mailing Address - State:NJ
Mailing Address - Zip Code:08210-2138
Mailing Address - Country:US
Mailing Address - Phone:609-463-2789
Mailing Address - Fax:609-463-2787
Practice Address - Street 1:129 BREAKWATER RD
Practice Address - Street 2:
Practice Address - City:CAPE MAY
Practice Address - State:NJ
Practice Address - Zip Code:08204-3707
Practice Address - Country:US
Practice Address - Phone:609-675-0910
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-08-08
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1061144133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered