Provider Demographics
NPI:1407911209
Name:CONLON, GERALDINE E (RD, CDE)
Entity Type:Individual
Prefix:MS
First Name:GERALDINE
Middle Name:E
Last Name:CONLON
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 1:12386 SHERIDAN CIR
Mailing Address - Street 2:
Mailing Address - City:SARATOGA
Mailing Address - State:CA
Mailing Address - Zip Code:95070-3834
Mailing Address - Country:US
Mailing Address - Phone:408-851-9999
Mailing Address - Fax:408-851-4259
Practice Address - Street 1:12386 SHERIDAN CIR
Practice Address - Street 2:
Practice Address - City:SARATOGA
Practice Address - State:CA
Practice Address - Zip Code:95070-3834
Practice Address - Country:US
Practice Address - Phone:408-851-9999
Practice Address - Fax:408-851-4259
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered