Individual
MARINA SHERESHEVSKY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CN
Contact information
Practice address
140 BOULEVARD, MOUNTAIN LAKES, NJ 07046-1201
(973) 216-0864
Mailing address
140 BOULEVARD, MOUNTAIN LAKES, NJ 07046-1201
(973) 216-0864
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
64083102
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
64083102
AADP
—
Enumeration date
02/25/2014
Last updated
02/25/2014
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