Nutricultures | |
292 Bloomfield Ave Fl 2, Montclair, NJ 07042-3624 | |
(201) 207-2158 | |
Not Available |
Full Name | Nutricultures |
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Type | Facility |
Speciality | Dietitian, Registered - Nutrition, Metabolic |
Location | 292 Bloomfield Ave Fl 2, Montclair, New Jersey |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1194284844 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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133VN1006X | Dietitian, Registered - Nutrition, Metabolic | (* (Not Available)) | Primary |
Provider Name | Mercy K. Edziah |
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Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
Provider Identifiers | NPI Number: 1881152510 PECOS PAC ID: 6800139346 Enrollment ID: I20190523002286 |
Mailing Address | Practice Location Address |
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Nutricultures 292 Bloomfield Ave Fl 2, Montclair, NJ 07042-3624 Ph: (201) 207-2158 | Nutricultures 292 Bloomfield Ave Fl 2, Montclair, NJ 07042-3624 Ph: (201) 207-2158 |
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