Sobha Malla, RD, CSR
Dietitian, Registered, Nutrition, Renal in Randolph, NJ. Individual provider (NPI-1).
NPI number1801286240
StatusActive
Last updated in NPPESNov 16, 2023
Details
- NPI
- 1801286240
- Entity type
- Individual (NPI-1)
- Name
- Sobha Malla
- Credential
- RD, CSR
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 23, 2015
- Certification date
- Nov 16, 2023
- Last updated
- Nov 16, 2023
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 133VN1005X | Dietitian, Registered, Nutrition, Renal | 931194 | NJ | Yes |
Practice location
121 Center Grove RdRandolph, NJ 07869-4453
Phone 315-834-2382
Mailing address
121 Center Grove RdRandolph, NJ 07869-4453
Phone 510-792-2652
Other practice locations
1096 Scenic Gulf Dr Ph 1602
Miramar Beach, FL 32550-7015
Miramar Beach, FL 32550-7015
Phone 510-792-2652
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