Provider Demographics
NPI:1881226124
Name:GROSS, ALLISON (RDN)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:GROSS
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 MERCER ST APT 17K
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10003-6738
Mailing Address - Country:US
Mailing Address - Phone:201-310-4194
Mailing Address - Fax:
Practice Address - Street 1:300 MERCER ST APT 17K
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-6738
Practice Address - Country:US
Practice Address - Phone:201-310-4194
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-02-05
Last Update Date:2020-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered