Provider Demographics
NPI:1770126617
Name:GARELICK, DOREEN SHULMAN (RD)
Entity type:Individual
Prefix:
First Name:DOREEN
Middle Name:SHULMAN
Last Name:GARELICK
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 1:24 INDIAN RUN RD
Mailing Address - Street 2:
Mailing Address - City:PRINCETON JUNCTION
Mailing Address - State:NJ
Mailing Address - Zip Code:08550-1406
Mailing Address - Country:US
Mailing Address - Phone:609-240-4649
Mailing Address - Fax:
Practice Address - Street 1:24 INDIAN RUN RD
Practice Address - Street 2:
Practice Address - City:PRINCETON JUNCTION
Practice Address - State:NJ
Practice Address - Zip Code:08550-1406
Practice Address - Country:US
Practice Address - Phone:609-240-4649
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-23
Last Update Date:2019-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered