Provider Demographics
NPI:1841593258
Name:ADAMS, ALISON ANGEL (RD)
Entity Type:Individual
Prefix:MS
First Name:ALISON
Middle Name:ANGEL
Last Name:ADAMS
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:PO BOX 127
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:NY
Mailing Address - Zip Code:10990-0127
Mailing Address - Country:US
Mailing Address - Phone:845-987-5197
Mailing Address - Fax:
Practice Address - Street 1:15 MAPLE AVENUE
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:NY
Practice Address - Zip Code:10990-0127
Practice Address - Country:US
Practice Address - Phone:845-987-5197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-08
Last Update Date:2010-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL01002756133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered