Organization
THE BRAZILIAN DIETITIAN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. GIRLENE BARBON DE PAIVA COUGHLIN RDN (OWNER)
(908) 616-7410
Entity
Organization
Contact information
Practice address
361 LAFAYETTE ST, NEWARK, NJ 07105-2723
(973) 535-5229
Mailing address
673 TENEYCK AVE, LYNDHURST, NJ 07071-2829
(908) 616-7410
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
03/18/2018
Last updated
03/18/2018
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