Provider Demographics
NPI:1831221290
Name:GULATI, ANITA K (MS RD LDN LICENSED D)
Entity type:Individual
Prefix:MRS
First Name:ANITA
Middle Name:K
Last Name:GULATI
Suffix:
Gender:F
Credentials:MS RD LDN LICENSED D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:370 MIDDLETOWN BLVD
Mailing Address - Street 2:#509 OXFORD SQUARE
Mailing Address - City:LANGHORNE
Mailing Address - State:PA
Mailing Address - Zip Code:19047
Mailing Address - Country:US
Mailing Address - Phone:215-741-1900
Mailing Address - Fax:
Practice Address - Street 1:370 MIDDLETOWN BLVD
Practice Address - Street 2:#509 OXFORD SQUARE
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047
Practice Address - Country:US
Practice Address - Phone:215-741-1900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN002284133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA2791584OtherAETNA US HEALTHCARE HMO I