Individual
MR. BENJAMIN FREDERICK BEIDEMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
610 LACEY RD UNIT 749, FORKED RIVER, NJ 08731-8037
(732) 930-1820
Mailing address
610 LACEY RD UNIT 749, FORKED RIVER, NJ 08731-8037
(732) 930-1820
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
NOT REQUIRED
NJ
133NN1002X
Nutrition Education Nutritionist
NOT REQUIRED
NJ
Other
Enumeration date
12/26/2015
Last updated
10/27/2020
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