Individual
ELIO C. MAYORGA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, RD, CDN
Contact information
Practice address
143 FORT LEE RD APT A, TEANECK, NJ 07666-3962
(347) 680-9637
Mailing address
143 FORT LEE RD APT A, TEANECK, NJ 07666-3962
(347) 680-9637
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86063287
NY
Other
Enumeration date
10/29/2019
Last updated
10/29/2019
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