Provider Demographics
NPI:1093314247
Name:PELLEGRINO, ALLISA GLADYS (MS, RD, LDN)
Entity type:Individual
Prefix:MRS
First Name:ALLISA
Middle Name:GLADYS
Last Name:PELLEGRINO
Suffix:
Gender:
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 WINDCHIME CT
Mailing Address - Street 2:
Mailing Address - City:FUQUAY VARINA
Mailing Address - State:NC
Mailing Address - Zip Code:27526-4365
Mailing Address - Country:US
Mailing Address - Phone:401-338-8704
Mailing Address - Fax:
Practice Address - Street 1:6013 FARRINGTON RD STE 201
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-8173
Practice Address - Country:US
Practice Address - Phone:401-338-8704
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-20
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1004XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Pediatric
No133V00000XDietary & Nutritional Service ProvidersDietitian, Registered