Provider Demographics
NPI:1750113262
Name:DELISSIO, JULIA (RDN)
Entity type:Individual
Prefix:
First Name:JULIA
Middle Name:
Last Name:DELISSIO
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 1:378 STAFFORD ST
Mailing Address - Street 2:
Mailing Address - City:CHERRY VALLEY
Mailing Address - State:MA
Mailing Address - Zip Code:01611-3343
Mailing Address - Country:US
Mailing Address - Phone:718-702-0432
Mailing Address - Fax:
Practice Address - Street 1:378 STAFFORD ST
Practice Address - Street 2:
Practice Address - City:CHERRY VALLEY
Practice Address - State:MA
Practice Address - Zip Code:01611-3343
Practice Address - Country:US
Practice Address - Phone:718-702-0432
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-08-14
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered