Provider Demographics
NPI:1689931248
Name:CUNNINGHAM, HEATHER A (RD, CNSC)
Entity Type:Individual
Prefix:MS
First Name:HEATHER
Middle Name:A
Last Name:CUNNINGHAM
Suffix:
Gender:F
Credentials:RD, CNSC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 HOSPITAL PLZ
Mailing Address - Street 2:
Mailing Address - City:OLD BRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:08857-3012
Mailing Address - Country:US
Mailing Address - Phone:732-324-5277
Mailing Address - Fax:732-324-4674
Practice Address - Street 1:1 HOSPITAL PLZ
Practice Address - Street 2:
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-3012
Practice Address - Country:US
Practice Address - Phone:732-324-5277
Practice Address - Fax:732-324-4674
Is Sole Proprietor?:No
Enumeration Date:2012-04-19
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ845902133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered