Provider Demographics
NPI:1982247656
Name:MAIN DISH NUTRITION
Entity Type:Organization
Organization Name:MAIN DISH NUTRITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:EMILIA
Authorized Official - Middle Name:ROSE
Authorized Official - Last Name:SOCHOVKA
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RDN
Authorized Official - Phone:908-892-2818
Mailing Address - Street 1:22 PEAPACK ROAD
Mailing Address - Street 2:PO BOX 158
Mailing Address - City:FAR HILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07931
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:22 PEAPACK RD
Practice Address - Street 2:
Practice Address - City:FAR HILLS
Practice Address - State:NJ
Practice Address - Zip Code:07931-2437
Practice Address - Country:US
Practice Address - Phone:908-234-1160
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-10-24
Last Update Date:2019-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty