Provider Demographics
NPI:1821531260
Name:FORMULAS FOR FITNESS
Entity Type:Organization
Organization Name:FORMULAS FOR FITNESS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:M
Authorized Official - Last Name:PARROTT
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD
Authorized Official - Phone:732-939-7147
Mailing Address - Street 1:51 SANDBURG DR
Mailing Address - Street 2:
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-1478
Mailing Address - Country:US
Mailing Address - Phone:732-939-7147
Mailing Address - Fax:
Practice Address - Street 1:51 SANDBURG DR
Practice Address - Street 2:
Practice Address - City:MORGANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07751-1478
Practice Address - Country:US
Practice Address - Phone:732-939-7147
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-12-01
Last Update Date:2016-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ875318133VN1006X
174400000X, 1744R1102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, MetabolicGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No1744R1102XOther Service ProvidersSpecialistResearch StudyGroup - Multi-Specialty