Healthcare Provider Details

I. General information

NPI: 1679200414
Provider Name (Legal Business Name): JACQUELINE GIULIVO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2022
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

880 KINNEAR RD
COLUMBUS OH
43212-1443
US

IV. Provider business mailing address

1435 NORTHWEST BLVD
COLUMBUS OH
43212-3059
US

V. Phone/Fax

Practice location:
  • Phone: 614-437-9002
  • Fax:
Mailing address:
  • Phone: 440-781-7106
  • 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: