Individual
ELIZABETH BONGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
525 CENTRAL AVE STE D, WESTFIELD, NJ 07090-2545
(908) 389-1910
Mailing address
77 BRANT AVE STE 200, CLARK, NJ 07066-1540
(732) 382-0091
(732) 382-8570
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
04/10/2006
Last updated
01/13/2020
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