Provider Demographics
NPI:1841455466
Name:HAZARD, PAULA S (RD)
Entity type:Individual
Prefix:MRS
First Name:PAULA
Middle Name:S
Last Name:HAZARD
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 1:9100 WESCOTT DR
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-4670
Mailing Address - Country:US
Mailing Address - Phone:908-237-6920
Mailing Address - Fax:908-237-6922
Practice Address - Street 1:9100 WESCOTT DR
Practice Address - Street 2:SUITE 102
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-4670
Practice Address - Country:US
Practice Address - Phone:908-237-6920
Practice Address - Fax:908-237-6922
Is Sole Proprietor?:No
Enumeration Date:2008-07-23
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ809550133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ135519Q6EMedicare PIN