Provider Demographics
NPI:1356099618
Name:GISELERD NUTRITION SERVICES, LLC
Entity type:Organization
Organization Name:GISELERD NUTRITION SERVICES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:GISELE
Authorized Official - Middle Name:
Authorized Official - Last Name:GAFFNEY
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LDN
Authorized Official - Phone:617-824-0932
Mailing Address - Street 1:100 COMMANDANTS WAY APT 101
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02150-4040
Mailing Address - Country:US
Mailing Address - Phone:617-824-0932
Mailing Address - Fax:888-384-3912
Practice Address - Street 1:867 BOYLSTON ST FL 12155
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02116-2774
Practice Address - Country:US
Practice Address - Phone:617-824-0932
Practice Address - Fax:888-384-3912
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-16
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty