Provider Demographics
NPI:1881275931
Name:BISOGNO, GABRIELLE MARIE (RD)
Entity type:Individual
Prefix:
First Name:GABRIELLE
Middle Name:MARIE
Last Name:BISOGNO
Suffix:
Gender:
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 KENTUCKY LN
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19055-2401
Mailing Address - Country:US
Mailing Address - Phone:609-462-4753
Mailing Address - Fax:
Practice Address - Street 1:76 STIRLING RD STE 201
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059-5778
Practice Address - Country:US
Practice Address - Phone:908-755-5437
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-20
Last Update Date:2025-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ86176274133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered