Provider Demographics
NPI:1861922767
Name:BREWSTER, GERI (RD MPH)
Entity type:Individual
Prefix:MS
First Name:GERI
Middle Name:
Last Name:BREWSTER
Suffix:
Gender:F
Credentials:RD MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 CATOONAH ST UNIT 115
Mailing Address - Street 2:
Mailing Address - City:RIDGEFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06877-7705
Mailing Address - Country:US
Mailing Address - Phone:914-864-1976
Mailing Address - Fax:914-864-1967
Practice Address - Street 1:274 OLD SIB RD
Practice Address - Street 2:
Practice Address - City:RIDGEFIELD
Practice Address - State:CT
Practice Address - Zip Code:06877-2316
Practice Address - Country:US
Practice Address - Phone:914-864-1976
Practice Address - Fax:914-864-1967
Is Sole Proprietor?:No
Enumeration Date:2017-06-14
Last Update Date:2017-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CTR637092133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered