Provider Demographics
NPI:1639347800
Name:MEJATT DIETETICS INC
Entity Type:Organization
Organization Name:MEJATT DIETETICS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, REGISTERED DIETITINA
Authorized Official - Prefix:MRS
Authorized Official - First Name:ESTHER
Authorized Official - Middle Name:F
Authorized Official - Last Name:ADESINA
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD
Authorized Official - Phone:908-303-7949
Mailing Address - Street 1:48 RESERVOIR RD
Mailing Address - Street 2:
Mailing Address - City:HACKETTSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07840-5647
Mailing Address - Country:US
Mailing Address - Phone:908-303-7949
Mailing Address - Fax:908-979-9797
Practice Address - Street 1:48 RESERVOIR RD
Practice Address - Street 2:
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-5647
Practice Address - Country:US
Practice Address - Phone:908-303-7949
Practice Address - Fax:908-979-9797
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-11
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ00890332133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJQ37810Medicare UPIN
NJ088901Medicare PIN