Provider Demographics
NPI:1871792465
Name:CELENTANO, CORINNE L (MS, CNS)
Entity type:Individual
Prefix:MS
First Name:CORINNE
Middle Name:L
Last Name:CELENTANO
Suffix:
Gender:F
Credentials:MS, CNS
Other - Prefix:MS
Other - First Name:CORINNE
Other - Middle Name:L
Other - Last Name:BUSH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MS, CNS
Mailing Address - Street 1:102 FAIRVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:LONG VALLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07853-3173
Mailing Address - Country:US
Mailing Address - Phone:908-234-1101
Mailing Address - Fax:
Practice Address - Street 1:405 MAIN ST
Practice Address - Street 2:
Practice Address - City:BEDMINSTER
Practice Address - State:NJ
Practice Address - Zip Code:07921-2605
Practice Address - Country:US
Practice Address - Phone:908-234-1101
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-13
Last Update Date:2007-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist