Provider Demographics
NPI:1811191901
Name:LANZETTA, DOROTHY J (MS, CDN)
Entity Type:Individual
Prefix:MS
First Name:DOROTHY
Middle Name:J
Last Name:LANZETTA
Suffix:
Gender:F
Credentials:MS, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 RUTGERS RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:NJ
Mailing Address - Zip Code:08527-2320
Mailing Address - Country:US
Mailing Address - Phone:848-448-8330
Mailing Address - Fax:
Practice Address - Street 1:4 RUTGERS RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:NJ
Practice Address - Zip Code:08527-2320
Practice Address - Country:US
Practice Address - Phone:848-448-8330
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-12
Last Update Date:2016-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist