Provider Demographics
NPI:1114092285
Name:GITTENS, SHEILA ANN (RD - CDE - CDN)
Entity Type:Individual
Prefix:MS
First Name:SHEILA
Middle Name:ANN
Last Name:GITTENS
Suffix:
Gender:F
Credentials:RD - CDE - CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:760 BROADWAY - WOODHULL HOSPITAL CENTER
Mailing Address - Street 2:DEPARTMENT OF AMBULATORY CARE ROOM #2AB-235'
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206
Mailing Address - Country:US
Mailing Address - Phone:718-724-2421
Mailing Address - Fax:718-630-3122
Practice Address - Street 1:760 BROADWAY WOODHULL HOSPITAL CENTER
Practice Address - Street 2:DEPARTMENT OF AMBULATORY CARE ROOM #2AB-235
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206
Practice Address - Country:US
Practice Address - Phone:718-724-2421
Practice Address - Fax:718-630-3122
Is Sole Proprietor?:No
Enumeration Date:2006-11-22
Last Update Date:2013-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003405133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered