Provider Demographics
NPI:1710208160
Name:CELLINI, ALYSSA
Entity Type:Individual
Prefix:MS
First Name:ALYSSA
Middle Name:
Last Name:CELLINI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 NEW BRUNSWICK AVE
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-3870
Mailing Address - Country:US
Mailing Address - Phone:732-926-9250
Mailing Address - Fax:
Practice Address - Street 1:4500 NEW BRUNSWICK AVE
Practice Address - Street 2:
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08854-3870
Practice Address - Country:US
Practice Address - Phone:732-926-9250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-21
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist