Provider Demographics
NPI:1225174360
Name:TENERALLI, RACHEL ELLEN (MS, RD, CSP)
Entity Type:Individual
Prefix:MRS
First Name:RACHEL
Middle Name:ELLEN
Last Name:TENERALLI
Suffix:
Gender:F
Credentials:MS, RD, CSP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:357 BOWLER CT
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-6648
Mailing Address - Country:US
Mailing Address - Phone:732-868-8407
Mailing Address - Fax:
Practice Address - Street 1:201 LYONS AVE
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:NJ
Practice Address - Zip Code:07112-2027
Practice Address - Country:US
Practice Address - Phone:973-926-4607
Practice Address - Fax:973-926-6288
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Not Answered133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ2390360OtherUNITED HEALTH CARE
NJ3547391HMOOtherAETNA US HEALTH CARE
NJNO REC051806OtherOXFORD HEALTH PLAN
NJNO REC051806OtherOXFORD HEALTH PLAN