Provider Demographics
NPI:1821417106
Name:GARRISON, ASHLEY KRZYSIK (RD)
Entity Type:Individual
Prefix:
First Name:ASHLEY
Middle Name:KRZYSIK
Last Name:GARRISON
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 HAMBURG TPKE STE 303
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-2173
Mailing Address - Country:US
Mailing Address - Phone:973-720-6733
Mailing Address - Fax:973-389-4098
Practice Address - Street 1:234 HAMBURG TPKE STE 303
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-2173
Practice Address - Country:US
Practice Address - Phone:973-720-6733
Practice Address - Fax:973-389-4098
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-15
Last Update Date:2020-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ86053891133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered