Provider Demographics
NPI:1306497458
Name:ADDORISIO, DENISE J (RD)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:J
Last Name:ADDORISIO
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 WESTLAKE DR
Mailing Address - Street 2:
Mailing Address - City:VALHALLA
Mailing Address - State:NY
Mailing Address - Zip Code:10595-1239
Mailing Address - Country:US
Mailing Address - Phone:914-682-7808
Mailing Address - Fax:
Practice Address - Street 1:115 BROADWAY
Practice Address - Street 2:
Practice Address - City:DOBBS FERRY
Practice Address - State:NY
Practice Address - Zip Code:10522-2835
Practice Address - Country:US
Practice Address - Phone:914-326-3199
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-09-20
Last Update Date:2019-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered