Provider Demographics
NPI:1326571175
Name:CONLON, BETH A (PHD, RD)
Entity type:Individual
Prefix:DR
First Name:BETH
Middle Name:A
Last Name:CONLON
Suffix:
Gender:F
Credentials:PHD, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 CHARLES RD
Mailing Address - Street 2:
Mailing Address - City:STIRLING
Mailing Address - State:NJ
Mailing Address - Zip Code:07980-1032
Mailing Address - Country:US
Mailing Address - Phone:908-331-0876
Mailing Address - Fax:
Practice Address - Street 1:2 NORTH RD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059-7184
Practice Address - Country:US
Practice Address - Phone:908-291-3609
Practice Address - Fax:866-336-9583
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-08
Last Update Date:2025-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133VN1004X, 133VN1201X
NJ01000047133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric
No133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight Management