Provider Demographics
NPI:1740775113
Name:BATCHELOR, SAMANTHA (RD, LDN)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:
Last Name:BATCHELOR
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 LOMOND RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08094-2930
Mailing Address - Country:US
Mailing Address - Phone:609-472-1339
Mailing Address - Fax:
Practice Address - Street 1:413 W CRYSTAL LAKE AVE
Practice Address - Street 2:
Practice Address - City:HADDONFIELD
Practice Address - State:NJ
Practice Address - Zip Code:08033
Practice Address - Country:US
Practice Address - Phone:609-472-1339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-27
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN006486133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered