Provider Demographics
NPI:1700389269
Name:GOLDFINE, MICHELE (MS, RD, CDN)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:GOLDFINE
Suffix:
Gender:F
Credentials:MS, RD, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 EVERETT RD
Mailing Address - Street 2:
Mailing Address - City:DEMAREST
Mailing Address - State:NJ
Mailing Address - Zip Code:07627-1225
Mailing Address - Country:US
Mailing Address - Phone:201-657-2867
Mailing Address - Fax:
Practice Address - Street 1:60 EVERETT ROAD
Practice Address - Street 2:
Practice Address - City:DEMAREST
Practice Address - State:NJ
Practice Address - Zip Code:07627-0762
Practice Address - Country:US
Practice Address - Phone:646-543-6281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-12
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered