Organization
LAUREN BLOOM RD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LAUREN BLOOM MHA RD CDN CDE (OWNER)
(973) 738-6763
Entity
Organization
Contact information
Practice address
517 REGAL BLVD, LIVINGSTON, NJ 07039-8245
(973) 738-6763
Mailing address
517 REGAL BLVD, LIVINGSTON, NJ 07039-8245
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
85007641
NJ
Other
Enumeration date
10/01/2010
Last updated
10/01/2010
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