Provider Demographics
NPI:1003994575
Name:CHLODNICKI, JULIANNE YANAS (REGISTERED DIETITIAN)
Entity Type:Individual
Prefix:MS
First Name:JULIANNE
Middle Name:YANAS
Last Name:CHLODNICKI
Suffix:
Gender:F
Credentials:REGISTERED DIETITIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 N CAPE TRL
Mailing Address - Street 2:
Mailing Address - City:ROCKAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:07866-4723
Mailing Address - Country:US
Mailing Address - Phone:973-625-9503
Mailing Address - Fax:
Practice Address - Street 1:20 N CAPE TRL
Practice Address - Street 2:
Practice Address - City:ROCKAWAY
Practice Address - State:NJ
Practice Address - Zip Code:07866-4723
Practice Address - Country:US
Practice Address - Phone:973-625-9503
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2023-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1003994575Medicaid