Provider Demographics
NPI:1194514596
Name:SISBARRO, DANA (RD)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:
Last Name:SISBARRO
Suffix:
Gender:
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:953 ROSEMONT AVE N
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-8340
Mailing Address - Country:US
Mailing Address - Phone:908-400-2732
Mailing Address - Fax:
Practice Address - Street 1:953 ROSEMONT AVE N
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-8340
Practice Address - Country:US
Practice Address - Phone:908-400-2732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-02
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered