Provider Demographics
NPI:1386827285
Name:GOLDSTEIN, CAROLE L (MS RD CDE)
Entity Type:Individual
Prefix:
First Name:CAROLE
Middle Name:L
Last Name:GOLDSTEIN
Suffix:
Gender:F
Credentials:MS RD CDE
Other - Prefix:
Other - First Name:CAROLE
Other - Middle Name:L
Other - Last Name:NUSSBAUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS RD CDE
Mailing Address - Street 1:77 LAMBERTVILLE HOPEWELL RD
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08525-2903
Mailing Address - Country:US
Mailing Address - Phone:609-333-0370
Mailing Address - Fax:
Practice Address - Street 1:77 LAMBERTVILLE HOPEWELL RD
Practice Address - Street 2:
Practice Address - City:HOPEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08525-2903
Practice Address - Country:US
Practice Address - Phone:609-333-0370
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-13
Last Update Date:2015-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ845867133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered