Provider Demographics
NPI:1396326583
Name:GENTILETTI, AYLA (RD)
Entity type:Individual
Prefix:
First Name:AYLA
Middle Name:
Last Name:GENTILETTI
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 1:3345 HAWTHORN CT
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08361-8805
Mailing Address - Country:US
Mailing Address - Phone:856-305-8686
Mailing Address - Fax:
Practice Address - Street 1:3345 HAWTHORN CT
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08361-8805
Practice Address - Country:US
Practice Address - Phone:856-305-8686
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-19
Last Update Date:2021-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86091378133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered