Provider Demographics
NPI:1942657713
Name:NOW(NUTRITION, OBESITY, WEIGHT MANAGEMENT) PROGRAM FOR KIDS
Entity Type:Organization
Organization Name:NOW(NUTRITION, OBESITY, WEIGHT MANAGEMENT) PROGRAM FOR KIDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NUTRITIONIST, CERT.PERSONAL TRAINER
Authorized Official - Prefix:MS
Authorized Official - First Name:FREENA
Authorized Official - Middle Name:R
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:CPT
Authorized Official - Phone:609-439-2129
Mailing Address - Street 1:416 BELLEVUE AVE
Mailing Address - Street 2:305
Mailing Address - City:TRENTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08618-4513
Mailing Address - Country:US
Mailing Address - Phone:609-439-2129
Mailing Address - Fax:609-337-8002
Practice Address - Street 1:416 BELLEVUE AVE
Practice Address - Street 2:305
Practice Address - City:TRENTON
Practice Address - State:NJ
Practice Address - Zip Code:08618-4513
Practice Address - Country:US
Practice Address - Phone:609-439-2129
Practice Address - Fax:609-337-8002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-20
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Single Specialty