Provider Demographics
NPI:1629314406
Name:DORFMAN, JULIE G (MA, RD, LDN)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:G
Last Name:DORFMAN
Suffix:
Gender:F
Credentials:MA, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 DOWNING LN
Mailing Address - Street 2:
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-4176
Mailing Address - Country:US
Mailing Address - Phone:856-448-4660
Mailing Address - Fax:
Practice Address - Street 1:52 BERLIN RD
Practice Address - Street 2:SUITE 1000
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08034-3574
Practice Address - Country:US
Practice Address - Phone:856-448-4660
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-23
Last Update Date:2012-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN003633133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered