Provider Demographics
NPI:1801586441
Name:GERSHBERG, AIMEE M
Entity type:Individual
Prefix:
First Name:AIMEE
Middle Name:M
Last Name:GERSHBERG
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 1:22 ARCADIA RD
Mailing Address - Street 2:
Mailing Address - City:WOODCLIFF LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07677-7806
Mailing Address - Country:US
Mailing Address - Phone:201-515-0468
Mailing Address - Fax:
Practice Address - Street 1:22 ARCADIA RD
Practice Address - Street 2:
Practice Address - City:WOODCLIFF LAKE
Practice Address - State:NJ
Practice Address - Zip Code:07677-7806
Practice Address - Country:US
Practice Address - Phone:201-515-0468
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-08
Last Update Date:2023-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered