Healthcare Provider Details

I. General information

NPI: 1184917718
Provider Name (Legal Business Name): JOANNE GORDON RD, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JOANNE HILLS

II. Dates (important events)

Enumeration Date: 05/16/2011
Last Update Date: 05/20/2025
Certification Date: 05/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 ROBIN CT
HAMPTON NJ
08827-2508
US

IV. Provider business mailing address

34 ROBIN CT
HAMPTON NJ
08827-2508
US

V. Phone/Fax

Practice location:
  • Phone: 908-227-6996
  • Fax: 908-932-0581
Mailing address:
  • Phone: 908-227-6996
  • Fax: 908-932-0581

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDN004575
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: