Provider Demographics
NPI:1326589458
Name:TREMBULAK, KRISTIE (MA, RDN, CDE)
Entity Type:Individual
Prefix:
First Name:KRISTIE
Middle Name:
Last Name:TREMBULAK
Suffix:
Gender:F
Credentials:MA, RDN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 CRESCENT PL
Mailing Address - Street 2:
Mailing Address - City:CRANFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07016-1805
Mailing Address - Country:US
Mailing Address - Phone:203-984-4296
Mailing Address - Fax:
Practice Address - Street 1:620 CRANBURY RD
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-4098
Practice Address - Country:US
Practice Address - Phone:732-967-0055
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-08
Last Update Date:2017-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered