Individual
MRS. MARILYN MOORE DRISCOLL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
201 LYONS AVENUE, NEWARK, NJ 07112
(973) 926-4607
(973) 926-6288
Mailing address
7-24 LAKE STREET, FAIR LAWN, NJ 07410
(201) 796-8336
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
719760
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2339245
UNITED HEALTH CARE
NJ
01
—
3478305
AETNA US HEALTH CARE
NJ
01
—
P2951221
OXFORD HEALTH PLAN
NJ
Enumeration date
01/31/2007
Last updated
07/08/2007
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