Individual
SAMANTHA ROSE PANKIW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
12 DANIEL DR, CEDAR GROVE, NJ 07009-1527
(551) 689-8359
Mailing address
12 DANIEL DR, CEDAR GROVE, NJ 07009-1527
(551) 689-8359
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
86052714
NJ
Other
Enumeration date
08/03/2022
Last updated
08/03/2022
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