Basic Information
| Provider Information | |||||||||
| NPI: | 1104158914 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | EDOUARD | ||||||||
| FirstName: | MARGARETTE | ||||||||
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| Credential: | RD, CDE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 204 CEDAR HILL AVE | ||||||||
| Address2: | |||||||||
| City: | NYACK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 109602423 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8453007606 | ||||||||
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| Practice Location | |||||||||
| Address1: | 610 VALLEY HEALTH PLZ | ||||||||
| Address2: | CARE PLUS NJ | ||||||||
| City: | PARAMUS | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 076523607 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2012658200 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/03/2010 | ||||||||
| LastUpdateDate: | 02/03/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X | 874048 | IL | Y | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.