Provider Demographics
NPI:1548887284
Name:KKG NUTRITION
Entity type:Organization
Organization Name:KKG NUTRITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, NUTRITIONIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:KARIN
Authorized Official - Middle Name:
Authorized Official - Last Name:GRUMET
Authorized Official - Suffix:
Authorized Official - Credentials:RD CEDRD
Authorized Official - Phone:908-770-2977
Mailing Address - Street 1:48 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901-6505
Mailing Address - Country:US
Mailing Address - Phone:908-770-2977
Mailing Address - Fax:
Practice Address - Street 1:48 MAPLE ST
Practice Address - Street 2:
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-6505
Practice Address - Country:US
Practice Address - Phone:908-770-2977
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-29
Last Update Date:2020-06-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Single Specialty