Organization
TAVARES MEDICAL NUTRITION THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELLE TAVARES RD (REGISTERED DIETITIAN)
(201) 704-4654
Entity
Organization
Contact information
Practice address
1100 AVENUE AT PORT IMPERIAL APT 910, WEEHAWKEN, NJ 07086-6303
(201) 704-4654
Mailing address
1100 AVENUE AT PORT IMPERIAL APT 910, WEEHAWKEN, NJ 07086-6303
(201) 704-4654
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
11/10/2020
Last updated
11/10/2020
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