Provider Demographics
NPI:1184917718
Name:GORDON, JOANNE (RD, LDN)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:GORDON
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:JOANNE
Other - Middle Name:
Other - Last Name:HILLS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:34 ROBIN CT
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08827-2508
Mailing Address - Country:US
Mailing Address - Phone:908-227-6996
Mailing Address - Fax:908-932-0581
Practice Address - Street 1:34 ROBIN CT
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:NJ
Practice Address - Zip Code:08827-2508
Practice Address - Country:US
Practice Address - Phone:908-227-6996
Practice Address - Fax:908-932-0581
Is Sole Proprietor?:No
Enumeration Date:2011-05-16
Last Update Date:2025-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN004575133V00000X
133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered