Provider Demographics
NPI:1700077955
Name:SIERRA, MARGARITA (MBA, RDN)
Entity type:Individual
Prefix:MS
First Name:MARGARITA
Middle Name:
Last Name:SIERRA
Suffix:
Gender:F
Credentials:MBA, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:389 E RANDOLPH AVE
Mailing Address - Street 2:
Mailing Address - City:MINE HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:07803-3070
Mailing Address - Country:US
Mailing Address - Phone:862-707-8404
Mailing Address - Fax:973-328-1432
Practice Address - Street 1:389 E RANDOLPH AVE
Practice Address - Street 2:
Practice Address - City:MINE HILL
Practice Address - State:NJ
Practice Address - Zip Code:07803-3070
Practice Address - Country:US
Practice Address - Phone:862-707-8404
Practice Address - Fax:973-328-1432
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ877964133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJR058035Medicare UPIN