NPI 1528350568

The Center for Medical Weight Loss of Bergen County,llc

Organisation Dietary Manager Englewood, NJ

Practice location

Address: 363 Grand Ave, Englewood, NJ 07631-4104
Phone: (201) 568-5936
Fax: (201) 568-7567

Authorised official

Name: Deane a Penn
Title: Manager
Phone: (201) 568-5936

Registered specialties

Dietary Manager Primary

Dietary & Nutritional Service Providers Taxonomy 132700000X Licence 25MA02573000 (NJ)

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Registry record

NPI: 1528350568
Entity type: Organization
NPI issued: 10 May 2011
Record last updated: 10 May 2011

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.