Provider Demographics
NPI:1154951788
Name:KRUGLYAK, ELINA (RDN)
Entity type:Individual
Prefix:
First Name:ELINA
Middle Name:
Last Name:KRUGLYAK
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 TICE RD APT 207
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN LAKES
Mailing Address - State:NJ
Mailing Address - Zip Code:07417-1468
Mailing Address - Country:US
Mailing Address - Phone:973-727-1260
Mailing Address - Fax:973-874-5313
Practice Address - Street 1:8 TICE RD
Practice Address - Street 2:APT 207
Practice Address - City:FRANKLIN LAKES
Practice Address - State:NJ
Practice Address - Zip Code:07417-0741
Practice Address - Country:US
Practice Address - Phone:973-727-1260
Practice Address - Fax:973-874-5313
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-23
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ86047698133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered