Provider Demographics
NPI:1134516529
Name:GRODNITZKY, CHRISTY PICKERING (MA, RD, LDN)
Entity Type:Individual
Prefix:
First Name:CHRISTY
Middle Name:PICKERING
Last Name:GRODNITZKY
Suffix:
Gender:F
Credentials:MA, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:57 W TIMONIUM RD
Mailing Address - Street 2:SUITE 111
Mailing Address - City:LUTHERVILLE TIMONIUM
Mailing Address - State:MD
Mailing Address - Zip Code:21093-3125
Mailing Address - Country:US
Mailing Address - Phone:410-989-1886
Mailing Address - Fax:410-630-1668
Practice Address - Street 1:57 W TIMONIUM RD
Practice Address - Street 2:SUITE 111
Practice Address - City:LUTHERVILLE TIMONIUM
Practice Address - State:MD
Practice Address - Zip Code:21093-3125
Practice Address - Country:US
Practice Address - Phone:410-989-1886
Practice Address - Fax:410-630-1668
Is Sole Proprietor?:No
Enumeration Date:2015-04-23
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDX2713133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered