HACKENSACK MERIDIAN NUTRITION NPI 1063057024

NPI Information

  • NPI: 1063057024
  • Provider Name: HACKENSACK MERIDIAN NUTRITION
  • Classification: Clinic/Center - 261QM1300X
  • Specialization: Multi-Specialty
  • Entity Type: Organization
  • CLIA Number: 31D2198549
  • Address: 27 S COOKS BRIDGE RD STE 1-03
    JACKSON, NJ
    ZIP 08527
  • Phone: (732) 928-1126

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NPI Details

HACKENSACK MERIDIAN NUTRITION is a multi-specialty clinic center in Jackson, NJ. HACKENSACK MERIDIAN NUTRITION NPI is 1063057024. The provider is registered as an organization entity type.

The provider's business location address is:

27 S COOKS BRIDGE RD STE 1-03
JACKSON, NJ
ZIP 08527-460
Phone: (732) 928-1126
Fax: (609) 601-1162

The provider's authorized official is James Clarke .
The authorized official title is Md and has the following contact phone number (732) 807-0877.

The CLIA number assigned to this NPI record is 31D2198549 - mobile laboratory with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/14/2019 and was last updated on 3/9/2020.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QM1300XClinic/CenterMulti-SpecialtyYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

NPI Synchronization or Removal

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