Provider Demographics
NPI:1699223750
Name:MEIRA WALDMAN RD LLC
Entity Type:Organization
Organization Name:MEIRA WALDMAN RD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:MEIRA
Authorized Official - Middle Name:R
Authorized Official - Last Name:WALDMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS RD
Authorized Official - Phone:732-363-2010
Mailing Address - Street 1:205 WYNATT ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-4839
Mailing Address - Country:US
Mailing Address - Phone:732-363-2010
Mailing Address - Fax:848-373-2499
Practice Address - Street 1:205 WYNATT ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-4839
Practice Address - Country:US
Practice Address - Phone:732-363-2010
Practice Address - Fax:848-373-2499
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-19
Last Update Date:2016-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty