Provider Demographics
NPI:1265748107
Name:GULI, KATELYN (RD)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:
Last Name:GULI
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 1:16 ARLENE DR
Mailing Address - Street 2:
Mailing Address - City:WEST LONG BRANCH
Mailing Address - State:NJ
Mailing Address - Zip Code:07764-1002
Mailing Address - Country:US
Mailing Address - Phone:908-883-0062
Mailing Address - Fax:
Practice Address - Street 1:279 3RD AVE STE 101
Practice Address - Street 2:
Practice Address - City:LONG BRANCH
Practice Address - State:NJ
Practice Address - Zip Code:07740-6209
Practice Address - Country:US
Practice Address - Phone:732-923-6082
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-30
Last Update Date:2019-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133V00000X
DEDN0000412133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered