Provider Demographics
NPI:1437471380
Name:PAM GERSTMAN DIETITIAN/NUTRITIONIST PLLC
Entity Type:Organization
Organization Name:PAM GERSTMAN DIETITIAN/NUTRITIONIST PLLC
Other - Org Name:NUTRITION BY PAM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:PAMELA
Authorized Official - Middle Name:BETH
Authorized Official - Last Name:GERSTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:516-728-2851
Mailing Address - Street 1:8 DELL DR
Mailing Address - Street 2:
Mailing Address - City:EAST ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11518-2108
Mailing Address - Country:US
Mailing Address - Phone:516-728-2851
Mailing Address - Fax:516-284-6768
Practice Address - Street 1:8 DELL DR
Practice Address - Street 2:
Practice Address - City:EAST ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11518-2108
Practice Address - Country:US
Practice Address - Phone:516-728-2851
Practice Address - Fax:516-284-6768
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-02-19
Last Update Date:2010-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006821133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty