Provider Demographics
NPI:1871750968
Name:LAIFER, SCOTT (RD)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:
Last Name:LAIFER
Suffix:
Gender:M
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:PO BOX 948
Mailing Address - Street 2:
Mailing Address - City:GREEN BROOK
Mailing Address - State:NJ
Mailing Address - Zip Code:08812-0948
Mailing Address - Country:US
Mailing Address - Phone:908-281-1090
Mailing Address - Fax:732-968-3944
Practice Address - Street 1:390 ROUTE 206
Practice Address - Street 2:
Practice Address - City:HILLSBOROUGH
Practice Address - State:NJ
Practice Address - Zip Code:08844-5523
Practice Address - Country:US
Practice Address - Phone:908-281-1090
Practice Address - Fax:732-968-3944
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-17
Last Update Date:2008-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ850715133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJP2163489OtherOXFORD