Allyson Joan Mitidieri, RDN | |
123 Barcroft Dr, Cherry Hill, NJ 08034-3126 | |
(856) 304-4120 | |
Not Available |
Full Name | Allyson Joan Mitidieri |
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Gender | Female |
Speciality | Dietitian, Registered |
Location | 123 Barcroft Dr, Cherry Hill, New Jersey |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1982152450 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
133V00000X | Dietitian, Registered | 1099452 (New Jersey) | Primary |
Provider Name | Advocare Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1770538696 PECOS PAC ID: 3678562188 Enrollment ID: O20040510001217 |
Provider Name | Virtua Medical Group, Pa |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1649226515 PECOS PAC ID: 9830222397 Enrollment ID: O20100804000338 |
Mailing Address | Practice Location Address |
---|---|
Allyson Joan Mitidieri, RDN 123 Barcroft Dr, Cherry Hill, NJ 08034-3126 Ph: (856) 304-4120 | Allyson Joan Mitidieri, RDN 123 Barcroft Dr, Cherry Hill, NJ 08034-3126 Ph: (856) 304-4120 |
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