Provider Demographics
NPI:1891153383
Name:TERRY R NEWMAN, RDN LLC
Entity Type:Organization
Organization Name:TERRY R NEWMAN, RDN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:TERRY
Authorized Official - Middle Name:R
Authorized Official - Last Name:NEWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:732-915-3093
Mailing Address - Street 1:846 WILLIAM DR
Mailing Address - Street 2:
Mailing Address - City:BRIELLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08730-1738
Mailing Address - Country:US
Mailing Address - Phone:732-915-3093
Mailing Address - Fax:732-223-1587
Practice Address - Street 1:200 ATLANTIC AVE
Practice Address - Street 2:SUITE NUMBER 15
Practice Address - City:MANASQUAN
Practice Address - State:NJ
Practice Address - Zip Code:08736-1352
Practice Address - Country:US
Practice Address - Phone:732-292-9800
Practice Address - Fax:732-223-1587
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-01-29
Last Update Date:2016-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ706228133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty