Individual
NICOLE CERILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
150A LONG BEACH BLVD, LONG BEACH TOWNSHIP, NJ 08008-6133
(609) 389-3464
Mailing address
27 S COOKS BRIDGE RD, STE 2-3, JACKSON, NJ 08527-2524
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
1025509
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1025509
RD LICENSE NUMBER
NJ
Enumeration date
03/14/2014
Last updated
06/30/2016
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