Provider Demographics
NPI:1023587250
Name:CHAMOUN, JULIEN (RD, MS)
Entity type:Individual
Prefix:
First Name:JULIEN
Middle Name:
Last Name:CHAMOUN
Suffix:
Gender:M
Credentials:RD, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:547 UNION BLVD
Mailing Address - Street 2:
Mailing Address - City:TOTOWA
Mailing Address - State:NJ
Mailing Address - Zip Code:07512-2404
Mailing Address - Country:US
Mailing Address - Phone:973-692-7901
Mailing Address - Fax:
Practice Address - Street 1:547 UNION BLVD
Practice Address - Street 2:
Practice Address - City:TOTOWA
Practice Address - State:NJ
Practice Address - Zip Code:07512-2404
Practice Address - Country:US
Practice Address - Phone:973-692-7901
Practice Address - Fax:973-692-7985
Is Sole Proprietor?:Yes
Enumeration Date:2018-11-16
Last Update Date:2021-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ86059743133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered