| Nourish Your Body, Llc | |
|
1376 Pompton Ave, Cedar Grove, NJ 07009-1011 | |
| (973) 200-0896 | |
| (844) 436-5129 |
| Full Name | Nourish Your Body, Llc |
|---|---|
| Type | Facility |
| Speciality | Dietitian, Registered |
| Location | 1376 Pompton Ave, Cedar Grove, New Jersey |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679874184 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 133V00000X | Dietitian, Registered | 933904 (New Jersey) | Primary |
| Provider Name | Elise Chassen Sopov |
|---|---|
| Provider Type | Practitioner - Registered Dietitian Or Nutrition Professional |
| Provider Identifiers | NPI Number: 1639254162 PECOS PAC ID: 7618076589 Enrollment ID: I20070619000395 |
| Mailing Address | Practice Location Address |
|---|---|
| Nourish Your Body, Llc 71 Bergen Dr, Little Falls, NJ 07424-1341 Ph: (973) 200-0896 | Nourish Your Body, Llc 1376 Pompton Ave, Cedar Grove, NJ 07009-1011 Ph: (973) 200-0896 |
Elise Chassen Sopov, Dietitian Medicare: Accepting Medicare Assignments Practice Location: 1376 Pompton Ave, Cedar Grove, NJ 07009 Phone: 973-200-0896 Fax: 844-436-5129 | |
Katelyn Wilson, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 143a E Bradford Ave, Cedar Grove, NJ 07009 Phone: 973-698-3901 | |
Samantha Rose Pankiw, RD Dietitian Medicare: Not Enrolled in Medicare Practice Location: 12 Daniel Dr, Cedar Grove, NJ 07009 Phone: 551-689-8359 |