Cusack, Katlyn
Cusack, Katlyn is an sole proprietor health care provider with primary practice located at 1201 Springwood Ave Ste 104 , Asbury Park NJ 07712-6796. She recently has only one registered license in Dietary & Nutritional Service Providers / Dietitian, Registered, which is considered as her primary health care specialty. Cusack, Katlyn can be contacted via phone (732) 539-3584.Contact Information
Primary practice address
1201 Springwood Ave Ste 104
Asbury Park NJ 07712-6796
Phone: (732) 539-3584
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dietary & Nutritional Service Providers / Dietitian, Registered | 133V00000X | 86103286 | New Jersey |
Profile Details
| NPI number | 1104489426 |
|---|---|
| LBN Legal business name | Cusack, Katlyn |
| Credentials | MS, RDN |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 22nd, 2019 |
| Last updated | Apr 22nd, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104489426 | NPPES |
| New Jersey | Other | 86103286 | CDR |
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