Provider Demographics
NPI:1427855949
Name:PERROTTA, ALEXA (MS, RDN, LDN)
Entity type:Individual
Prefix:
First Name:ALEXA
Middle Name:
Last Name:PERROTTA
Suffix:
Gender:
Credentials:MS, RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 MOHAWK XING
Mailing Address - Street 2:
Mailing Address - City:SUSSEX
Mailing Address - State:NJ
Mailing Address - Zip Code:07461-4539
Mailing Address - Country:US
Mailing Address - Phone:973-650-5709
Mailing Address - Fax:
Practice Address - Street 1:3 MOHAWK XING
Practice Address - Street 2:
Practice Address - City:SUSSEX
Practice Address - State:NJ
Practice Address - Zip Code:07461-4539
Practice Address - Country:US
Practice Address - Phone:973-650-5709
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ86197830133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered