Provider Demographics
NPI:1831946326
Name:GALASCIO, MADISON (RDN, LDN)
Entity type:Individual
Prefix:
First Name:MADISON
Middle Name:
Last Name:GALASCIO
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4424 JACKSON AVE APT 648
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-1906
Mailing Address - Country:US
Mailing Address - Phone:973-461-6783
Mailing Address - Fax:
Practice Address - Street 1:4424 JACKSON AVE APT 648
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-1906
Practice Address - Country:US
Practice Address - Phone:973-461-6783
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-02
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXDT90113133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered