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NPI 1790763647

NPI 1790763647 : ROBERTA W GERSHNER MS, RD, CDN : OSSINING, NY

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General NPI Number Information
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    NPI Number           |    1790763647
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    Entity Type          |    Individual 
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    Provider Name        |    ROBERTA W GERSHNER MS, RD, CDN
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    Gender               |    Female 
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Dates
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    Enumeration Date     |    01/02/2006
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    Last Update Date     |    07/08/2007
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Provider Practice Location Address
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    Address Line         |    42 STONEGATE RD 
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    City                 |    OSSINING
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    State                |    NY
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    Zip                  |    10562-4015
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    Country              |    US
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    Telephone            |    914-762-6024
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    Fax                  |    914-762-6719
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Provider Business Mailing Address
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    Address Line         |    42 STONEGATE RD 
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    City                 |    OSSINING
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    State                |    NY
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    Zip                  |    10562-4015
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    Country              |    US
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    Telephone            |    914-762-6024
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    Fax                  |    914-762-6719
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    133V00000X
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    Taxonomy Name        |    Registered Dietitian
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    License Number       |    002542-1
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    License Number State |    NY
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