Provider Demographics
NPI:1083587802
Name:SUGRUE, ANNE M (RD)
Entity type:Individual
Prefix:
First Name:ANNE
Middle Name:M
Last Name:SUGRUE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:920 CLARIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07762-2209
Mailing Address - Country:US
Mailing Address - Phone:732-500-4209
Mailing Address - Fax:
Practice Address - Street 1:920 CLARIDGE DR
Practice Address - Street 2:
Practice Address - City:SPRING LAKE
Practice Address - State:NJ
Practice Address - Zip Code:07762-2209
Practice Address - Country:US
Practice Address - Phone:732-500-4209
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-26
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1094858133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered