Individual
MISS ELLEN MAULBECK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
280 BLOOMFIELD AVE, VERONA, NJ 07044-2426
(973) 610-9909
Mailing address
126 DEMAREST AVE., BLOOMFIELD, NJ 07003
(973) 610-9909
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1041863
NJ
Other
Enumeration date
12/09/2013
Last updated
12/09/2013
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