Healthcare Provider Details

I. General information

NPI: 1003094012
Provider Name (Legal Business Name): BARBARA J GIANNONE RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2008
Last Update Date: 02/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 W MAIN ST STE B
FREEHOLD NJ
07728-2579
US

IV. Provider business mailing address

1001 W MAIN ST STE B
FREEHOLD NJ
07728-2579
US

V. Phone/Fax

Practice location:
  • Phone: 732-294-2540
  • Fax: 732-294-9328
Mailing address:
  • Phone: 732-294-2540
  • Fax: 732-294-9328

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: