Basic Information
Provider Information | |||||||||
NPI: | 1407094899 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | SCHALDONE | ||||||||
FirstName: | NICOLE | ||||||||
MiddleName: | JEAN | ||||||||
NamePrefix: | MS. | ||||||||
NameSuffix: |   | ||||||||
Credential: | MS, RD, CSO | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | BAKER | ||||||||
OtherFirstName: | NICOLE | ||||||||
OtherMiddleName: | JEAN | ||||||||
OtherNamePrefix: | MRS. | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: | MS, RD, CSO | ||||||||
OtherLastNameType: | 5 | ||||||||
Mailing Information | |||||||||
Address1: | 1100 WESCOTT DR STE 201 | ||||||||
Address2: |   | ||||||||
City: | FLEMINGTON | ||||||||
State: | NJ | ||||||||
PostalCode: | 088224600 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9087884022 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 1100 WESCOTT DR STE 201 | ||||||||
Address2: |   | ||||||||
City: | FLEMINGTON | ||||||||
State: | NJ | ||||||||
PostalCode: | 088224600 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9087884022 | ||||||||
FaxNumber: |   | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 01/23/2009 | ||||||||
LastUpdateDate: | 05/14/2009 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | Y | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X | 00927860 | NJ | Y |   | Dietary & Nutritional Service Providers | Dietitian, Registered |   |
No ID Information.