Provider Demographics
NPI:1477084689
Name:GURSKY ALLEN, MICHELLE JENNIFER (MS, RD, CDN)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:JENNIFER
Last Name:GURSKY ALLEN
Suffix:
Gender:F
Credentials:MS, RD, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 TAYLORS MILLS RD
Mailing Address - Street 2:
Mailing Address - City:MANALAPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07726-3229
Mailing Address - Country:US
Mailing Address - Phone:732-780-7333
Mailing Address - Fax:732-358-0921
Practice Address - Street 1:227 TAYLORS MILLS RD
Practice Address - Street 2:
Practice Address - City:MANALAPAN
Practice Address - State:NJ
Practice Address - Zip Code:07726-3229
Practice Address - Country:US
Practice Address - Phone:732-780-7333
Practice Address - Fax:732-358-0921
Is Sole Proprietor?:No
Enumeration Date:2017-03-21
Last Update Date:2017-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ918847133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered