Provider Demographics
NPI:1003039116
Name:GENTILE, ROSEMARY E (RD)
Entity Type:Individual
Prefix:MS
First Name:ROSEMARY
Middle Name:E
Last Name:GENTILE
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 VALLEY ST
Mailing Address - Street 2:
Mailing Address - City:WATERFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06385-3619
Mailing Address - Country:US
Mailing Address - Phone:860-437-3027
Mailing Address - Fax:
Practice Address - Street 1:22 VALLEY ST
Practice Address - Street 2:
Practice Address - City:WATERFORD
Practice Address - State:CT
Practice Address - Zip Code:06385-3619
Practice Address - Country:US
Practice Address - Phone:860-437-3027
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered