Provider Demographics
NPI:1669275079
Name:JACLYN RD NUTRITION AND WELLNESS SOLUTIONS
Entity type:Organization
Organization Name:JACLYN RD NUTRITION AND WELLNESS SOLUTIONS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JACLYN
Authorized Official - Middle Name:
Authorized Official - Last Name:PADOVANO
Authorized Official - Suffix:
Authorized Official - Credentials:RD, CDCES
Authorized Official - Phone:201-655-5697
Mailing Address - Street 1:385 TERRACE LN
Mailing Address - Street 2:
Mailing Address - City:BEDMINSTER
Mailing Address - State:NJ
Mailing Address - Zip Code:07921-1927
Mailing Address - Country:US
Mailing Address - Phone:201-655-5697
Mailing Address - Fax:
Practice Address - Street 1:385 TERRACE LN
Practice Address - Street 2:
Practice Address - City:BEDMINSTER
Practice Address - State:NJ
Practice Address - Zip Code:07921-1927
Practice Address - Country:US
Practice Address - Phone:908-532-3185
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-03-31
Last Update Date:2025-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty
No133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight ManagementGroup - Multi-Specialty
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, MetabolicGroup - Multi-Specialty