Healthcare Provider Details

I. General information

NPI: 1831221290
Provider Name (Legal Business Name): ANITA K GULATI MS RD LDN LICENSED D
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/12/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

370 MIDDLETOWN BLVD #509 OXFORD SQUARE
LANGHORNE PA
19047
US

IV. Provider business mailing address

370 MIDDLETOWN BLVD #509 OXFORD SQUARE
LANGHORNE PA
19047
US

V. Phone/Fax

Practice location:
  • Phone: 215-741-1900
  • Fax:
Mailing address:
  • Phone: 215-741-1900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License NumberDN002284
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: