Individual
UNKNOWN DENNIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RD
Contact information
Practice address
140 BERGEN ST, NEWARK, NJ 07103-2425
(862) 872-2880
Mailing address
24 JONES ST APT 407, NEWARK, NJ 07103-3843
(862) 872-2880
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86325724
NJ
Other
Enumeration date
03/16/2023
Last updated
03/16/2023
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