Provider Demographics
NPI:1336491299
Name:PIERRE, GERALDINE (RD, CDE)
Entity Type:Individual
Prefix:
First Name:GERALDINE
Middle Name:
Last Name:PIERRE
Suffix:
Gender:F
Credentials:RD, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:56 GARDEN VIEW TER UNIT 25
Mailing Address - Street 2:
Mailing Address - City:EAST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08520-4654
Mailing Address - Country:US
Mailing Address - Phone:732-322-7886
Mailing Address - Fax:
Practice Address - Street 1:56 GARDEN VIEW TER UNIT 25
Practice Address - Street 2:
Practice Address - City:EAST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08520
Practice Address - Country:US
Practice Address - Phone:732-322-7886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-02
Last Update Date:2018-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ21210296174H00000X
NJ0101111133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No174H00000XOther Service ProvidersHealth Educator