Provider Demographics
NPI:1881829570
Name:GARRITY, ILONA RAE (MBA, RD, LDN)
Entity Type:Individual
Prefix:
First Name:ILONA
Middle Name:RAE
Last Name:GARRITY
Suffix:
Gender:F
Credentials:MBA, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:704 MCGRANN BLVD
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17601-4517
Mailing Address - Country:US
Mailing Address - Phone:717-293-9192
Mailing Address - Fax:
Practice Address - Street 1:704 MCGRANN BLVD
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17601-4517
Practice Address - Country:US
Practice Address - Phone:717-293-9192
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-25
Last Update Date:2009-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN003160133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered