Provider Demographics
NPI:1639162878
Name:LOEW, JENNY ESTELLE (MS, RD, LD)
Entity Type:Individual
Prefix:MS
First Name:JENNY
Middle Name:ESTELLE
Last Name:LOEW
Suffix:
Gender:F
Credentials:MS, RD, LD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 STILES RD
Mailing Address - Street 2:SUITE 213
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079-2859
Mailing Address - Country:US
Mailing Address - Phone:603-898-9834
Mailing Address - Fax:603-898-8253
Practice Address - Street 1:23 STILES RD
Practice Address - Street 2:SUITE 213
Practice Address - City:SALEM
Practice Address - State:NH
Practice Address - Zip Code:03079-2859
Practice Address - Country:US
Practice Address - Phone:603-898-8934
Practice Address - Fax:603-898-8253
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-23
Last Update Date:2008-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH402133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH27Y008018NH01OtherANTHEM
NH468018OtherTUFTS
NH27Y008018NH01OtherANTHEM