Provider Demographics
NPI:1285360958
Name:SGHERZA, JACQUELINE GOMES (RDN, MBA)
Entity type:Individual
Prefix:MRS
First Name:JACQUELINE
Middle Name:GOMES
Last Name:SGHERZA
Suffix:
Gender:F
Credentials:RDN, MBA
Other - Prefix:
Other - First Name:JACQUELINE
Other - Middle Name:
Other - Last Name:GOMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN, MBA
Mailing Address - Street 1:8 STRATFORD CT
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:NJ
Mailing Address - Zip Code:07059-5573
Mailing Address - Country:US
Mailing Address - Phone:973-517-5903
Mailing Address - Fax:
Practice Address - Street 1:449 MAIN ST
Practice Address - Street 2:
Practice Address - City:LODI
Practice Address - State:NJ
Practice Address - Zip Code:07644-1818
Practice Address - Country:US
Practice Address - Phone:973-517-5903
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-26
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered