Provider Demographics
NPI:1790763647
Name:GERSHNER, ROBERTA W (MS, RD, CDN)
Entity Type:Individual
Prefix:MRS
First Name:ROBERTA
Middle Name:W
Last Name:GERSHNER
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 1:42 STONEGATE RD
Mailing Address - Street 2:
Mailing Address - City:OSSINING
Mailing Address - State:NY
Mailing Address - Zip Code:10562-4015
Mailing Address - Country:US
Mailing Address - Phone:914-762-6024
Mailing Address - Fax:914-762-6719
Practice Address - Street 1:42 STONEGATE RD
Practice Address - Street 2:
Practice Address - City:OSSINING
Practice Address - State:NY
Practice Address - Zip Code:10562-4015
Practice Address - Country:US
Practice Address - Phone:914-762-6024
Practice Address - Fax:914-762-6719
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002542-1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY03P121Medicare ID - Type Unspecified