Provider Demographics
NPI:1902970403
Name:RANKY, MARTI (RD)
Entity Type:Individual
Prefix:MS
First Name:MARTI
Middle Name:
Last Name:RANKY
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:226 BROOKSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-4631
Mailing Address - Country:US
Mailing Address - Phone:201-493-0521
Mailing Address - Fax:
Practice Address - Street 1:226 BROOKSIDE AVE
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-4631
Practice Address - Country:US
Practice Address - Phone:201-493-0521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
921978133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered