Provider Demographics
NPI:1053745695
Name:VINEIS, MARINA ANNE (RD)
Entity type:Individual
Prefix:
First Name:MARINA
Middle Name:ANNE
Last Name:VINEIS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 BLACK ROCK TER
Mailing Address - Street 2:
Mailing Address - City:RINGWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07456-2903
Mailing Address - Country:US
Mailing Address - Phone:973-476-8109
Mailing Address - Fax:
Practice Address - Street 1:1278 YARDVILLE ALLENTOWN RD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:NJ
Practice Address - Zip Code:08501-1866
Practice Address - Country:US
Practice Address - Phone:609-738-3143
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-31
Last Update Date:2013-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ01082681133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered