Provider Demographics
NPI:1942712682
Name:LEVINE, JENNIFER (MS, RD, CDN, CDCES)
Entity Type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:
Last Name:LEVINE
Suffix:
Gender:F
Credentials:MS, RD, CDN, CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:435 SOUTH ST STE 350
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-6474
Mailing Address - Country:US
Mailing Address - Phone:973-971-6700
Mailing Address - Fax:
Practice Address - Street 1:435 SOUTH ST STE 350
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-6474
Practice Address - Country:US
Practice Address - Phone:973-971-6700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-03
Last Update Date:2022-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86007769133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered