Healthcare Provider Details

I. General information

NPI: 1396251005
Provider Name (Legal Business Name): JESSICA GELMAN MS, RD, CDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/18/2017
Last Update Date: 08/20/2020
Certification Date: 08/20/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 RIDGE RD
ENGLEWOOD CLIFFS NJ
07632-1817
US

IV. Provider business mailing address

11 RIDGE RD
ENGLEWOOD CLIFFS NJ
07632-1817
US

V. Phone/Fax

Practice location:
  • Phone: 551-206-6749
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: