Organization
DIABETES MANAGEMENT SERVICES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY TIGUE RD (DIETITIAN)
(845) 598-7204
Entity
Organization
Contact information
Practice address
261 OLD HOOK RD, WESTWOOD, NJ 07675-3102
(845) 598-7204
(845) 201-8319
Mailing address
700-76 BROADWAY #344, WESTWOOD, NJ 07675-1674
(845) 598-7204
(845) 201-8319
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
163WD0400X
Diabetes Educator Registered Nurse
26NC07813500
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
127863
PTAN
NJ
01
—
569991
PTAN
NY
Enumeration date
09/08/2008
Last updated
04/10/2020
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