Provider Demographics
NPI:1881451250
Name:MEISEL, ALYSSA (LDN)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:MEISEL
Suffix:
Gender:F
Credentials:LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:443 KISTLER RD
Mailing Address - Street 2:
Mailing Address - City:ELLIOTTSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17024-9020
Mailing Address - Country:US
Mailing Address - Phone:717-636-3390
Mailing Address - Fax:
Practice Address - Street 1:111 S FRONT ST
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17101-2010
Practice Address - Country:US
Practice Address - Phone:717-782-3131
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-04
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN008350133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered