Provider Demographics
NPI:1356629570
Name:PITTMAN, ALYSSA ANNE (BS, RD, LDN)
Entity Type:Individual
Prefix:MISS
First Name:ALYSSA
Middle Name:ANNE
Last Name:PITTMAN
Suffix:
Gender:F
Credentials:BS, RD, LDN
Other - Prefix:
Other - First Name:ALYSSA
Other - Middle Name:ANNE
Other - Last Name:JOYCE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:34 BRUCE AVE
Mailing Address - Street 2:
Mailing Address - City:SHREWSBURY
Mailing Address - State:MA
Mailing Address - Zip Code:01545-3002
Mailing Address - Country:US
Mailing Address - Phone:774-329-6705
Mailing Address - Fax:
Practice Address - Street 1:34 BRUCE AVE
Practice Address - Street 2:
Practice Address - City:SHREWSBURY
Practice Address - State:MA
Practice Address - Zip Code:01545-3002
Practice Address - Country:US
Practice Address - Phone:774-329-6705
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-07-22
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA01093108133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered