Individual
AMY BOLTZ REGINA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
52 JOHN ST, RED BANK, NJ 07701-2338
(201) 994-5498
Mailing address
52 JOHN ST, RED BANK, NJ 07701-2338
(201) 994-5498
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
DN001274
PA
133V00000X
Registered Dietitian
Primary
DN001274
PA
Other
Enumeration date
09/25/2008
Last updated
01/12/2016
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