Provider Demographics
NPI:1871818435
Name:VINCENTO, ALLISON DEBRA (MS, RD)
Entity Type:Individual
Prefix:MS
First Name:ALLISON
Middle Name:DEBRA
Last Name:VINCENTO
Suffix:
Gender:F
Credentials:MS, RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 ETTL LN UNIT 22
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06831-4160
Mailing Address - Country:US
Mailing Address - Phone:914-715-2699
Mailing Address - Fax:203-532-5637
Practice Address - Street 1:40 ETTL LN UNIT 22
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06831-4160
Practice Address - Country:US
Practice Address - Phone:914-715-2699
Practice Address - Fax:203-532-5637
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-07
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133N00000X, 133V00000X
NY709637133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist