Provider Demographics
NPI:1730056425
Name:ESCOBAR, ANTHONY RICARDO (REGISTERED DIETITIAN)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:RICARDO
Last Name:ESCOBAR
Suffix:
Gender:M
Credentials:REGISTERED DIETITIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:221 RINGWOOD AVE APT A-7
Mailing Address - Street 2:
Mailing Address - City:POMPTON LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07442-2032
Mailing Address - Country:US
Mailing Address - Phone:862-345-4067
Mailing Address - Fax:862-345-4067
Practice Address - Street 1:221 RINGWOOD AVE APT A-7
Practice Address - Street 2:
Practice Address - City:POMPTON LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07442-2032
Practice Address - Country:US
Practice Address - Phone:862-345-4067
Practice Address - Fax:862-345-4067
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-20
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ86109371133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered