Provider Demographics
NPI:1588126692
Name:ERCOLE, LAUREN (RDN)
Entity type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:
Last Name:ERCOLE
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 1:26 CLIFFWOOD RD
Mailing Address - Street 2:
Mailing Address - City:CHESTER
Mailing Address - State:NJ
Mailing Address - Zip Code:07930-3100
Mailing Address - Country:US
Mailing Address - Phone:215-804-4456
Mailing Address - Fax:
Practice Address - Street 1:331 US HIGHWAY 206
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-4781
Practice Address - Country:US
Practice Address - Phone:908-431-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-05
Last Update Date:2019-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
998401133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered