Provider Demographics
NPI:1902642127
Name:JONES, RYAN M (RDN)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:M
Last Name:JONES
Suffix:
Gender:M
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:HAMBURG
Mailing Address - State:NJ
Mailing Address - Zip Code:07419-1100
Mailing Address - Country:US
Mailing Address - Phone:848-448-1025
Mailing Address - Fax:
Practice Address - Street 1:18 VILLAGE DR
Practice Address - Street 2:
Practice Address - City:HAMBURG
Practice Address - State:NJ
Practice Address - Zip Code:07419-1100
Practice Address - Country:US
Practice Address - Phone:848-448-1025
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-08
Last Update Date:2024-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ86254274133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered