Provider Demographics
NPI:1629608815
Name:GROFF, JESSICA (MS)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:
Last Name:GROFF
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 SEMINOLE AVE
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:NJ
Mailing Address - Zip Code:07436-2926
Mailing Address - Country:US
Mailing Address - Phone:551-497-8998
Mailing Address - Fax:
Practice Address - Street 1:62 SEMINOLE AVE
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:NJ
Practice Address - Zip Code:07436-2926
Practice Address - Country:US
Practice Address - Phone:551-497-8998
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-16
Last Update Date:2020-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education