Provider Demographics
NPI:1861609984
Name:SENDEROFF, JILL M (MA, RD, CDN)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:M
Last Name:SENDEROFF
Suffix:
Gender:F
Credentials:MA, RD, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 W END AVE
Mailing Address - Street 2:APT.#15E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-5601
Mailing Address - Country:US
Mailing Address - Phone:212-769-0295
Mailing Address - Fax:212-769-0295
Practice Address - Street 1:160 WEST END AVE
Practice Address - Street 2:APT.#15E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-5601
Practice Address - Country:US
Practice Address - Phone:212-769-0295
Practice Address - Fax:212-769-0295
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered