Provider Demographics
NPI:1972748846
Name:MERRELL, MARYANN FERRANTE (RD)
Entity Type:Individual
Prefix:MS
First Name:MARYANN
Middle Name:FERRANTE
Last Name:MERRELL
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 1:21 MARKET ST
Mailing Address - Street 2:
Mailing Address - City:PATERSON
Mailing Address - State:NJ
Mailing Address - Zip Code:07501-1723
Mailing Address - Country:US
Mailing Address - Phone:973-754-4230
Mailing Address - Fax:973-754-4259
Practice Address - Street 1:21 MARKET ST
Practice Address - Street 2:
Practice Address - City:PATERSON
Practice Address - State:NJ
Practice Address - Zip Code:07501-1723
Practice Address - Country:US
Practice Address - Phone:973-754-4230
Practice Address - Fax:973-754-4259
Is Sole Proprietor?:No
Enumeration Date:2008-12-08
Last Update Date:2008-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ566783133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered