Basic Information
| Provider Information | |||||||||
| NPI: | 1144565599 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HARTNETT | ||||||||
| FirstName: | KATHRYN | ||||||||
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| Credential: | R.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 176 PALISADE AVE | ||||||||
| Address2: | |||||||||
| City: | JERSEY CITY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 073061121 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2017958200 | ||||||||
| FaxNumber: | 2017958307 | ||||||||
| Practice Location | |||||||||
| Address1: | 176 PALISADE AVE | ||||||||
| Address2: | |||||||||
| City: | JERSEY CITY | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 073061121 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2017958200 | ||||||||
| FaxNumber: | 2017958307 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/11/2012 | ||||||||
| LastUpdateDate: | 12/11/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 133V00000X | Y | Dietary & Nutritional Service Providers | Dietitian, Registered |
No ID Information.