Provider Demographics
NPI:1386997815
Name:GERDNER, EMILY (RD, LDN, CDE)
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:GERDNER
Suffix:
Gender:F
Credentials:RD, LDN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 SHELTON RD
Mailing Address - Street 2:
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-5134
Mailing Address - Country:US
Mailing Address - Phone:609-558-2405
Mailing Address - Fax:888-855-7803
Practice Address - Street 1:500 BOSTON POST RD
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CT
Practice Address - Zip Code:06477-3530
Practice Address - Country:US
Practice Address - Phone:609-558-2405
Practice Address - Fax:888-855-7803
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-22
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered