Provider Demographics
NPI:1235268087
Name:GAFFNEY, SHARON JEAN (RD)
Entity Type:Individual
Prefix:MS
First Name:SHARON
Middle Name:JEAN
Last Name:GAFFNEY
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:175 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:BRANFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06405-3019
Mailing Address - Country:US
Mailing Address - Phone:203-483-4383
Mailing Address - Fax:203-483-4386
Practice Address - Street 1:175 N MAIN ST
Practice Address - Street 2:
Practice Address - City:BRANFORD
Practice Address - State:CT
Practice Address - Zip Code:06405-3019
Practice Address - Country:US
Practice Address - Phone:203-483-4383
Practice Address - Fax:203-483-4386
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000527133N00000X, 133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered133N00000XDietary & Nutritional Service ProvidersNutritionist
Not Answered133V00000XDietary & Nutritional Service ProvidersDietitian, Registered