Individual
COMFORT N EKUNNO-TABANSI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED DIETITIAN
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
(201) 491-9972
(973) 324-2218
Taxonomy
Speciality
Code
Description
License number
State
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
927499
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
097992U0Y
RENDERING NUMBER
NJ
Enumeration date
04/04/2007
Last updated
11/20/2007
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