Provider Demographics
NPI:1750321808
Name:IORILLO, KELLY (RD, MS)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:
Last Name:IORILLO
Suffix:
Gender:F
Credentials:RD, MS
Other - Prefix:
Other - First Name:KELLY
Other - Middle Name:
Other - Last Name:JANUZZI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, MS
Mailing Address - Street 1:1050 GALLOPING HILL RD
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-7983
Mailing Address - Country:US
Mailing Address - Phone:908-206-2230
Mailing Address - Fax:908-206-2237
Practice Address - Street 1:200 S ORANGE AVE
Practice Address - Street 2:
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-5817
Practice Address - Country:US
Practice Address - Phone:973-322-7073
Practice Address - Fax:973-322-7528
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ852504133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered