Provider Demographics
NPI:1932402450
Name:NJ NUTRITION SERVICES LLC
Entity Type:Organization
Organization Name:NJ NUTRITION SERVICES LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:LORI
Authorized Official - Middle Name:
Authorized Official - Last Name:KINGLEY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-283-1900
Mailing Address - Street 1:220 CENTENNIAL AVE
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-3940
Mailing Address - Country:US
Mailing Address - Phone:732-283-1900
Mailing Address - Fax:908-903-1672
Practice Address - Street 1:220 CENTENNIAL AVE
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-3940
Practice Address - Country:US
Practice Address - Phone:732-283-1900
Practice Address - Fax:908-903-1672
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-12-07
Last Update Date:2010-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty