| Edison Medical Nutrition Center | |
|
15 S Main St Edison NJ 08837-3447 | |
| (732) 906-8866 | |
| Not Available |
| Full Name | Edison Medical Nutrition Center |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 15 S Main St, Edison, New Jersey |
| Authorized Official Name and Position | Richard Barton Menashe (PHYSICIAN) |
| Authorized Official Contact | 7329068866 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Edison Medical Nutrition Center 15 S Main St Edison NJ 08837-3447 Ph: (732) 906-8866 | Edison Medical Nutrition Center 15 S Main St Edison NJ 08837-3447 Ph: (732) 906-8866 |
| NPI Number | 1528195468 |
|---|---|
| Provider Enumeration Date | 02/27/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1528195468 | NPI | - | NPPES |
| 047830 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | MB046474 (New Jersey) | Primary |
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