Provider Demographics
NPI:1588399331
Name:HEILMANN, MAUREEN CHRISTINA (RDN, CDCES)
Entity type:Individual
Prefix:
First Name:MAUREEN
Middle Name:CHRISTINA
Last Name:HEILMANN
Suffix:
Gender:F
Credentials:RDN, CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2156 EVERGREEN AVE
Mailing Address - Street 2:
Mailing Address - City:SEA GIRT
Mailing Address - State:NJ
Mailing Address - Zip Code:08750-1704
Mailing Address - Country:US
Mailing Address - Phone:732-796-8040
Mailing Address - Fax:
Practice Address - Street 1:2156 EVERGREEN AVE
Practice Address - Street 2:
Practice Address - City:SEA GIRT
Practice Address - State:NJ
Practice Address - Zip Code:08750-1704
Practice Address - Country:US
Practice Address - Phone:732-796-8040
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-17
Last Update Date:2022-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY635851133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered