Provider Demographics
NPI:1649168899
Name:KOUTSOUPIAS, MARIA (MSC, RD)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:KOUTSOUPIAS
Suffix:
Gender:F
Credentials:MSC, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:184 PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:SOUTH RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08882-1121
Mailing Address - Country:US
Mailing Address - Phone:973-370-9910
Mailing Address - Fax:
Practice Address - Street 1:184 PROSPECT ST
Practice Address - Street 2:
Practice Address - City:SOUTH RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08882-1121
Practice Address - Country:US
Practice Address - Phone:973-370-9910
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-26
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered