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Individual

MISS LUZVIMINDA MEGABUNG CABOTAJE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PH.D, RD

Contact information

Practice address
2065 KLOCKNER RD, HAMILTON, NJ 08690-3414
(609) 586-6321
(609) 586-7634
Mailing address
2065 KLOCKNER RD, HAMILTON, NJ 08690
(609) 586-6321
(609) 586-7634

Taxonomy

Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
812178
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
067448
MEDICARE PROVIDER ID NO.
NJ
Enumeration date
01/17/2008
Last updated
01/17/2008
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