Provider Demographics
NPI:1245064146
Name:TAYLOR, ALESSANDRA (MS, CNS)
Entity type:Individual
Prefix:MRS
First Name:ALESSANDRA
Middle Name:
Last Name:TAYLOR
Suffix:
Gender:F
Credentials:MS, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:198 MOORE AVE
Mailing Address - Street 2:
Mailing Address - City:LEONIA
Mailing Address - State:NJ
Mailing Address - Zip Code:07605-2010
Mailing Address - Country:US
Mailing Address - Phone:917-742-0771
Mailing Address - Fax:
Practice Address - Street 1:198 MOORE AVE
Practice Address - Street 2:
Practice Address - City:LEONIA
Practice Address - State:NJ
Practice Address - Zip Code:07605-2010
Practice Address - Country:US
Practice Address - Phone:917-742-0771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-02
Last Update Date:2024-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ133N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist