Provider Demographics
NPI:1255087706
Name:THARANI, JENIFER
Entity type:Individual
Prefix:
First Name:JENIFER
Middle Name:
Last Name:THARANI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 SHADY GOLFWAY
Mailing Address - Street 2:UNIT 1006
Mailing Address - City:TORONTO
Mailing Address - State:ON
Mailing Address - Zip Code:M3C3A5
Mailing Address - Country:CA
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5 SHADY GOLFWAY
Practice Address - Street 2:UNIT 1006
Practice Address - City:TORONTO
Practice Address - State:ON
Practice Address - Zip Code:M3C3A5
Practice Address - Country:CA
Practice Address - Phone:229-550-9352
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-23
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered