Provider Demographics
NPI:1760788764
Name:VASISHTA, SANGEETHA KUMAR (REGISTERED DIETETIAN)
Entity Type:Individual
Prefix:MRS
First Name:SANGEETHA
Middle Name:KUMAR
Last Name:VASISHTA
Suffix:
Gender:F
Credentials:REGISTERED DIETETIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 KESWICK RD
Mailing Address - Street 2:
Mailing Address - City:EAST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08520-2963
Mailing Address - Country:US
Mailing Address - Phone:609-336-7700
Mailing Address - Fax:
Practice Address - Street 1:19 KESWICK RD
Practice Address - Street 2:
Practice Address - City:EAST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08520-2963
Practice Address - Country:US
Practice Address - Phone:609-336-7700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-08
Last Update Date:2013-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ983823133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered