Provider Demographics
NPI:1043434442
Name:CHAKRABARTI, JULIANA VOCCA (MS, RD, CSP, LDN)
Entity Type:Individual
Prefix:MRS
First Name:JULIANA
Middle Name:VOCCA
Last Name:CHAKRABARTI
Suffix:
Gender:F
Credentials:MS, RD, CSP, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 BROADACRE DR
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-4705
Mailing Address - Country:US
Mailing Address - Phone:856-914-1428
Mailing Address - Fax:
Practice Address - Street 1:500 LIPPINCOTT DR
Practice Address - Street 2:
Practice Address - City:MARLTON
Practice Address - State:NJ
Practice Address - Zip Code:08053-4802
Practice Address - Country:US
Practice Address - Phone:856-914-1428
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN000975133VN1004X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric