Provider Demographics
NPI:1497528400
Name:BUCKLEY, JILLIAN CAMERON (RDN)
Entity Type:Individual
Prefix:
First Name:JILLIAN
Middle Name:CAMERON
Last Name:BUCKLEY
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:225 DOBSON LN
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-3806
Mailing Address - Country:US
Mailing Address - Phone:908-327-5499
Mailing Address - Fax:
Practice Address - Street 1:225 DOBSON LN
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-3806
Practice Address - Country:US
Practice Address - Phone:908-327-5499
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-01
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered