Provider Demographics
NPI:1407230386
Name:GEBO, ALYSHA (RD)
Entity Type:Individual
Prefix:
First Name:ALYSHA
Middle Name:
Last Name:GEBO
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:736 CAMBRIDGE ST
Mailing Address - Street 2:
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02141-1401
Mailing Address - Country:US
Mailing Address - Phone:617-789-3000
Mailing Address - Fax:
Practice Address - Street 1:51 PEMBROKE AVE
Practice Address - Street 2:
Practice Address - City:ACUSHNET
Practice Address - State:MA
Practice Address - Zip Code:02743-2346
Practice Address - Country:US
Practice Address - Phone:508-688-4794
Practice Address - Fax:508-974-9849
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-10
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered