Provider Demographics
NPI:1871040360
Name:GIRGIS, MARSHA (RD)
Entity Type:Individual
Prefix:
First Name:MARSHA
Middle Name:
Last Name:GIRGIS
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 1:20 DUNSTER ST
Mailing Address - Street 2:
Mailing Address - City:CARTERET
Mailing Address - State:NJ
Mailing Address - Zip Code:07008-1608
Mailing Address - Country:US
Mailing Address - Phone:732-632-7813
Mailing Address - Fax:
Practice Address - Street 1:2050 CENTER AVE
Practice Address - Street 2:STE. 325
Practice Address - City:FORT LEE
Practice Address - State:NJ
Practice Address - Zip Code:07024-4996
Practice Address - Country:US
Practice Address - Phone:201-944-0283
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2016-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ86085975133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered