Provider Demographics
NPI:1982308532
Name:SANCHEZ, NATHALIA
Entity Type:Individual
Prefix:
First Name:NATHALIA
Middle Name:
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 MOUNT PROSPECT AVE
Mailing Address - Street 2:
Mailing Address - City:DOVER
Mailing Address - State:NJ
Mailing Address - Zip Code:07801-3707
Mailing Address - Country:US
Mailing Address - Phone:973-580-3289
Mailing Address - Fax:
Practice Address - Street 1:9 MOUNT PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:DOVER
Practice Address - State:NJ
Practice Address - Zip Code:07801-3707
Practice Address - Country:US
Practice Address - Phone:973-580-3289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-28
Last Update Date:2024-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ86371664133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered