Emily Bostrom Nutrition PLLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

EMILY BOSTROM NUTRITION PLLC

Doing business as

Emily Gerdner Nutrition

Practice address

331 Shelton Rd
Trumbull, CT 06611-5134

Phone

(609) 558-2405

NPI assigned

Jan 27, 2021

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Emily Gerdner, RDNPI 1386997815

Title

Owner

Phone

(609) 558-2405

Specialties & licenses 1

Addresses

Other names 1

• Emily Gerdner Nutrition Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Emily Gerdner, R.D., L.D.N, C.D.E

  • Registered Dietitian
  • Orange, CT
  • NPI 1386997815
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1611705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611705600000",
    "number": "1508457185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "331 SHELTON RD",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066115134",
            "telephone_number": "609-558-2405"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "331 SHELTON RD",
            "city": "TRUMBULL",
            "state": "CT",
            "postal_code": "066115134",
            "telephone_number": "609-558-2405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMILY BOSTROM NUTRITION PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-27",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A",
        "authorized_official_last_name": "GERDNER",
        "authorized_official_first_name": "EMILY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "609-558-2405",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Emily Gerdner Nutrition",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinic/Center in Trumbull, CT
• Providers in Trumbull, CT by specialty
• Clinic/Center in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.