Provider Demographics
NPI:1700482254
Name:D'ADAMO, ALEXANDRA (RD)
Entity type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:D'ADAMO
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:LEXIE
Other - Middle Name:
Other - Last Name:D'ADAMO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RD
Mailing Address - Street 1:31 LENAPE TRL
Mailing Address - Street 2:
Mailing Address - City:CHATHAM
Mailing Address - State:NJ
Mailing Address - Zip Code:07928-1812
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:307 RARITAN AVE
Practice Address - Street 2:
Practice Address - City:HIGHLAND PARK
Practice Address - State:NJ
Practice Address - Zip Code:08904-2757
Practice Address - Country:US
Practice Address - Phone:862-308-0074
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-09
Last Update Date:2024-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133V00000X
86101333133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty