Provider Demographics
NPI:1053919704
Name:GEOFFROY, TIFFANY (RDN)
Entity type:Individual
Prefix:
First Name:TIFFANY
Middle Name:
Last Name:GEOFFROY
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 ORCHARD ST
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-2619
Mailing Address - Country:US
Mailing Address - Phone:973-699-1420
Mailing Address - Fax:
Practice Address - Street 1:39 ORCHARD ST
Practice Address - Street 2:
Practice Address - City:NUTLEY
Practice Address - State:NJ
Practice Address - Zip Code:07110-2619
Practice Address - Country:US
Practice Address - Phone:973-699-1420
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-14
Last Update Date:2020-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered