Provider Demographics
NPI:1972356301
Name:GERSTEIN, ABBY JO (RD, CDN)
Entity Type:Individual
Prefix:
First Name:ABBY
Middle Name:JO
Last Name:GERSTEIN
Suffix:
Gender:F
Credentials:RD, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 NEWTOWN LN
Mailing Address - Street 2:
Mailing Address - City:MELVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11747-1222
Mailing Address - Country:US
Mailing Address - Phone:917-204-0268
Mailing Address - Fax:
Practice Address - Street 1:30 NEWTOWN LN
Practice Address - Street 2:
Practice Address - City:MELVILLE
Practice Address - State:NY
Practice Address - Zip Code:11747-1222
Practice Address - Country:US
Practice Address - Phone:917-204-0268
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered