Provider Demographics
NPI:1811472350
Name:ALPHACISE LLC
Entity type:Organization
Organization Name:ALPHACISE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER, EMPLOYEE
Authorized Official - Prefix:MRS
Authorized Official - First Name:SAMARA
Authorized Official - Middle Name:
Authorized Official - Last Name:KRAFT
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RDN, CDE
Authorized Official - Phone:732-309-8936
Mailing Address - Street 1:4 BRANDYWINE DR
Mailing Address - Street 2:
Mailing Address - City:EAST BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08816-3313
Mailing Address - Country:US
Mailing Address - Phone:732-309-8936
Mailing Address - Fax:
Practice Address - Street 1:4 BRANDYWINE DR
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-3313
Practice Address - Country:US
Practice Address - Phone:732-309-8936
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-10-01
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty