Provider Demographics
NPI:1114531571
Name:CARROLL, ANNE COOK (RDN)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:COOK
Last Name:CARROLL
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 2ND ST APT 2103
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-3098
Mailing Address - Country:US
Mailing Address - Phone:516-528-1788
Mailing Address - Fax:
Practice Address - Street 1:2 2ND ST APT 2103
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-3098
Practice Address - Country:US
Practice Address - Phone:516-528-1788
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-03
Last Update Date:2020-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered