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Organization
GOCOPETRA CARE CONSULTANT LLC
Active
Organization
GOCOPETRA CARE CONSULTANT LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. COMFORT NWAMAKA EKUNNO-TABANSI (REGISTERED DIETITIAN)
(973) 731-7938
Entity
Organization
Contact information
Practice address
170 NORWOOD ST, NEWARK, NJ 07106-2627
(201) 491-9972
(973) 324-2218
Mailing address
540 HILLSIDE TER, WEST ORANGE, NJ 07052-4306
(973) 731-7938
(973) 324-2218
Taxonomy
Speciality
Code
Description
License number
State
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
927499
IL
Other
Enumeration date
09/08/2006
Last updated
11/20/2007
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