Healthcare Provider Details

I. General information

NPI: 1861559783
Provider Name (Legal Business Name): JINNY FRANZE GERSTLE R.D.,CDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

338 COLUMBUS AVE
WEST HARRISON NY
10604-2138
US

IV. Provider business mailing address

338 COLUMBUS AVE
WEST HARRISON NY
10604-2138
US

V. Phone/Fax

Practice location:
  • Phone: 914-949-4296
  • Fax: 914-831-1663
Mailing address:
  • Phone: 914-949-4296
  • Fax: 914-831-1663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number001148-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: