Provider Demographics
NPI:1891121000
Name:PILLITTERI, NICOLE KRISTIN (RD)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:KRISTIN
Last Name:PILLITTERI
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 1:1345 KUSER RD
Mailing Address - Street 2:SUITE 5
Mailing Address - City:HAMILTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08619-3823
Mailing Address - Country:US
Mailing Address - Phone:609-585-8400
Mailing Address - Fax:609-585-8401
Practice Address - Street 1:1345 KUSER RD
Practice Address - Street 2:SUITE 5
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-3823
Practice Address - Country:US
Practice Address - Phone:609-585-8400
Practice Address - Fax:609-585-8401
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-19
Last Update Date:2018-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ86014045133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered