Healthcare Provider Details

I. General information

NPI: 1255262424
Provider Name (Legal Business Name): CARLY GNEIDING RD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2026
Last Update Date: 05/27/2026
Certification Date: 05/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 E RTE 4 STE 490
PARAMUS NJ
07652-2622
US

IV. Provider business mailing address

80 E RTE 4 STE 490
PARAMUS NJ
07652-2622
US

V. Phone/Fax

Practice location:
  • Phone: 201-251-3480
  • Fax:
Mailing address:
  • Phone: 201-251-3480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133VN1201X
TaxonomyObesity and Weight Management Nutrition Registered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: