Provider Demographics
NPI:1962638783
Name:HUNTLEY, MAUREEN (CHC AADP)
Entity Type:Individual
Prefix:
First Name:MAUREEN
Middle Name:
Last Name:HUNTLEY
Suffix:
Gender:F
Credentials:CHC AADP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 MIDWOOD RD
Mailing Address - Street 2:
Mailing Address - City:GLEN ROCK
Mailing Address - State:NJ
Mailing Address - Zip Code:07452-1523
Mailing Address - Country:US
Mailing Address - Phone:201-670-4162
Mailing Address - Fax:
Practice Address - Street 1:42 MIDWOOD RD
Practice Address - Street 2:
Practice Address - City:GLEN ROCK
Practice Address - State:NJ
Practice Address - Zip Code:07452-1523
Practice Address - Country:US
Practice Address - Phone:201-670-4162
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-08
Last Update Date:2009-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist