Provider Demographics
NPI:1770690802
Name:GELZAINES, SHERI ANN (RD, CD-N)
Entity Type:Individual
Prefix:MS
First Name:SHERI
Middle Name:ANN
Last Name:GELZAINES
Suffix:
Gender:F
Credentials:RD, CD-N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:63 ELM ST APT 114
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:CT
Mailing Address - Zip Code:06040-5975
Mailing Address - Country:US
Mailing Address - Phone:860-585-3911
Mailing Address - Fax:
Practice Address - Street 1:BREWSTER ROAD
Practice Address - Street 2:
Practice Address - City:BRISTOL
Practice Address - State:CT
Practice Address - Zip Code:06011
Practice Address - Country:US
Practice Address - Phone:860-585-3911
Practice Address - Fax:860-585-3081
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000739133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered