Provider Demographics
NPI:1609166388
Name:MILONE, MAGGIE (NUTRITIONIST)
Entity type:Individual
Prefix:
First Name:MAGGIE
Middle Name:
Last Name:MILONE
Suffix:
Gender:F
Credentials:NUTRITIONIST
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 BRYANT AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081-1615
Mailing Address - Country:US
Mailing Address - Phone:845-800-3195
Mailing Address - Fax:
Practice Address - Street 1:420 MORRIS AVE STE 1
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-1149
Practice Address - Country:US
Practice Address - Phone:845-800-3195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-14
Last Update Date:2025-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007200133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered