Provider Demographics
NPI:1295381838
Name:HIRTES, GIAVONNA MARIA
Entity type:Individual
Prefix:
First Name:GIAVONNA
Middle Name:MARIA
Last Name:HIRTES
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:544 MOUNT HOPE RD
Mailing Address - Street 2:
Mailing Address - City:WHARTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07885-2816
Mailing Address - Country:US
Mailing Address - Phone:973-532-2095
Mailing Address - Fax:
Practice Address - Street 1:544 MOUNT HOPE RD
Practice Address - Street 2:
Practice Address - City:WHARTON
Practice Address - State:NJ
Practice Address - Zip Code:07885-2816
Practice Address - Country:US
Practice Address - Phone:973-532-2095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-09
Last Update Date:2025-05-06
Deactivation Date:2019-10-16
Deactivation Code:
Reactivation Date:2021-12-16
Provider Licenses
StateLicense IDTaxonomies
133N00000X
NJ86027972133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist