Provider Demographics
NPI:1669788766
Name:BIRKITT, AILEEN ELIZABETH
Entity type:Individual
Prefix:MS
First Name:AILEEN
Middle Name:ELIZABETH
Last Name:BIRKITT
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:PO BOX 23
Mailing Address - Street 2:
Mailing Address - City:PEAPACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07977-0023
Mailing Address - Country:US
Mailing Address - Phone:908-285-4537
Mailing Address - Fax:
Practice Address - Street 1:9 PROSPECT ST.
Practice Address - Street 2:
Practice Address - City:PEAPACK
Practice Address - State:NJ
Practice Address - Zip Code:07977-0023
Practice Address - Country:US
Practice Address - Phone:908-285-4537
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-26
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ922515133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered