Provider Demographics
NPI:1306574538
Name:NEFF, JUSTINA M (RD)
Entity type:Individual
Prefix:
First Name:JUSTINA
Middle Name:M
Last Name:NEFF
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 1:614 DELAWARE AVENUE
Mailing Address - Street 2:
Mailing Address - City:PALMERTON
Mailing Address - State:PA
Mailing Address - Zip Code:18071
Mailing Address - Country:US
Mailing Address - Phone:272-639-5305
Mailing Address - Fax:866-449-5832
Practice Address - Street 1:614 DELAWARE AVENUE
Practice Address - Street 2:
Practice Address - City:PALMERTON
Practice Address - State:PA
Practice Address - Zip Code:18071
Practice Address - Country:US
Practice Address - Phone:272-639-5305
Practice Address - Fax:866-449-5832
Is Sole Proprietor?:No
Enumeration Date:2022-08-15
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN007821133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered