Provider Demographics
NPI:1144467648
Name:GAJ, JANELLE K (RD, LDN)
Entity type:Individual
Prefix:MISS
First Name:JANELLE
Middle Name:K
Last Name:GAJ
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:183 LANCASTER AVE
Mailing Address - Street 2:
Mailing Address - City:MALVERN
Mailing Address - State:PA
Mailing Address - Zip Code:19355-2122
Mailing Address - Country:US
Mailing Address - Phone:610-240-9010
Mailing Address - Fax:610-240-0950
Practice Address - Street 1:183 LANCASTER AVE
Practice Address - Street 2:
Practice Address - City:MALVERN
Practice Address - State:PA
Practice Address - Zip Code:19355-2122
Practice Address - Country:US
Practice Address - Phone:610-240-9010
Practice Address - Fax:610-240-0950
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-21
Last Update Date:2009-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN003257133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered