Provider Demographics
NPI:1851849020
Name:BENGALI, MALEEHA (RD)
Entity Type:Individual
Prefix:
First Name:MALEEHA
Middle Name:
Last Name:BENGALI
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 BOGART DR
Mailing Address - Street 2:
Mailing Address - City:BRIDGEWATER
Mailing Address - State:NJ
Mailing Address - Zip Code:08807-5766
Mailing Address - Country:US
Mailing Address - Phone:908-393-6148
Mailing Address - Fax:
Practice Address - Street 1:19 BOGART DR
Practice Address - Street 2:
Practice Address - City:BRIDGEWATER
Practice Address - State:NJ
Practice Address - Zip Code:08807-5766
Practice Address - Country:US
Practice Address - Phone:908-393-6148
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-16
Last Update Date:2016-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL927254133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered