Provider Demographics
NPI:1831793447
Name:NATALIE GILLETT NUTRITION, L.L.C.
Entity type:Organization
Organization Name:NATALIE GILLETT NUTRITION, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GILLETT
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD
Authorized Official - Phone:973-460-7579
Mailing Address - Street 1:13 ROSELAND AVE
Mailing Address - Street 2:
Mailing Address - City:TOTOWA
Mailing Address - State:NJ
Mailing Address - Zip Code:07512-1506
Mailing Address - Country:US
Mailing Address - Phone:973-460-7579
Mailing Address - Fax:
Practice Address - Street 1:13 ROSELAND AVE
Practice Address - Street 2:
Practice Address - City:TOTOWA
Practice Address - State:NJ
Practice Address - Zip Code:07512-1506
Practice Address - Country:US
Practice Address - Phone:973-460-7579
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-24
Last Update Date:2020-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service