Provider Demographics
NPI:1013117563
Name:GHIRARDI, GINA MARIE (RD, LDN)
Entity Type:Individual
Prefix:MS
First Name:GINA
Middle Name:MARIE
Last Name:GHIRARDI
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:MRS
Other - First Name:GINA
Other - Middle Name:
Other - Last Name:DURANTE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, LDN
Mailing Address - Street 1:3350 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01107-1112
Mailing Address - Country:US
Mailing Address - Phone:413-794-3967
Mailing Address - Fax:413-794-5195
Practice Address - Street 1:3350 MAIN ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01107-1112
Practice Address - Country:US
Practice Address - Phone:413-794-3967
Practice Address - Fax:413-794-5195
Is Sole Proprietor?:No
Enumeration Date:2007-07-23
Last Update Date:2016-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2092133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered