Doctor Name: | PHYLLIS ANN HOLMES |
NPI Number: | 1053448134 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RD |
License Number: | 886131 |
Business Practice Address: | 27 Madison Ave Suite 50 Paramus, NJ - 076522722 |
Business Phone Number: | 8883695550 |
Business Fax Number: | 8883695550 |
Mailing Address: | 936 Midland Rd, ORADELL |
State: | NJ |
Postal Code: | 076491904 |
Phone Number: | 8883695550 |
Fax Number: | 8883695550 |
NPI Enumeration Date: | 02/27/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133NN1002X |
License Number: | 886131 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Nutritionist |
Taxonomy Specialization: | Nutrition, Education |
Taxonomy Definition: |