Provider Demographics
NPI:1164128880
Name:BUFFA, ALYSSA KARLEEN (RDN)
Entity Type:Individual
Prefix:
First Name:ALYSSA
Middle Name:KARLEEN
Last Name:BUFFA
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 1:2657 WALNUT RD
Mailing Address - Street 2:
Mailing Address - City:AUBURN HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48326-2121
Mailing Address - Country:US
Mailing Address - Phone:586-441-2335
Mailing Address - Fax:
Practice Address - Street 1:2657 WALNUT RD
Practice Address - Street 2:
Practice Address - City:AUBURN HILLS
Practice Address - State:MI
Practice Address - Zip Code:48326-2121
Practice Address - Country:US
Practice Address - Phone:586-441-2335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-03
Last Update Date:2023-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered