Basic Information
Provider Information | |||||||||
NPI: | 1205408739 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | PLOSS | ||||||||
FirstName: | MARGARET | ||||||||
MiddleName: |   | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | MS, RDN | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 45 OLD CHESTER RD | ||||||||
Address2: |   | ||||||||
City: | GLADSTONE | ||||||||
State: | NJ | ||||||||
PostalCode: | 079342030 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9083342187 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 200 SOMERSET ST | ||||||||
Address2: |   | ||||||||
City: | NEW BRUNSWICK | ||||||||
State: | NJ | ||||||||
PostalCode: | 089011942 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7322587000 | ||||||||
FaxNumber: | 7322581942 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 07/14/2021 | ||||||||
LastUpdateDate: | 07/14/2021 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 07/13/2021 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X |   |   | Y |   | Dietary & Nutritional Service Providers | Dietitian, Registered |   |
ID Information
ID | Type | State | Issuer | Description | 719519 | 01 |   | COMMISSION ON DIETETIC REGISTRATION | OTHER |