Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Dr. Mavis Camalita Ermakov, RD, RN, CDE, APN

Individual provider Registered Dietitian · NPI 1265614911

Dr. Mavis Camalita Ermakov, RD, RN, CDE, APN is a Registered Dietitian in Newark, New Jersey. Works from 2 locations. Licensed in Illinois and New Jersey.

Licensed in
IL, NJ
In the registry since
2007
Specialties on file
4
What do these letters mean?
RD — Registered Dietitian
A credentialed nutrition professional.
RN — Registered Nurse
A licensed nurse who completed a nursing degree and passed the NCLEX-RN examination.
CDE — Certified Diabetes Educator
Teaches people to manage diabetes day to day.
APN — Advanced Practice Nurse
The umbrella title some states use for nurse practitioners and other advanced practice nurses.

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Practice location Address checks out

741 Broadway
Newark, NJ 07104-4309
Phone: (973) 483-1300
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 731 Liberty Ct, Piscataway, NJ 08854-7206 — (732) 937-5952

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 26NJ00421400 (NJ)
Registered Dietitian Taxonomy 133V00000X · Licence 0071705 (IL)
Metabolic Nutrition Registered Dietitian Taxonomy 133VN1006X · Licence 717052 (ID#) (IL)
Diabetes Educator Registered Nurse Taxonomy 163WD0400X · Licence 26NR112011600 (NJ)

Record details

NPI number1265614911
Entity typeIndividual (Type 1)
GenderFemale
Credentials RD , RN , CDE , APN
Sole proprietorNo
NPI enumeratedDecember 4, 2007
Last updated in NPPESAugust 17, 2021
Certification dateAugust 17, 2021

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