Provider Demographics
NPI:1528474277
Name:TEDESCO, ALANA DUFFY (MS RD)
Entity type:Individual
Prefix:
First Name:ALANA
Middle Name:DUFFY
Last Name:TEDESCO
Suffix:
Gender:F
Credentials:MS RD
Other - Prefix:
Other - First Name:ALANA
Other - Middle Name:LEIGH
Other - Last Name:DUFFY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MS RD
Mailing Address - Street 1:331 NEWMAN SPRINGS RD
Mailing Address - Street 2:SUITE 143
Mailing Address - City:RED BANK
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-5688
Mailing Address - Country:US
Mailing Address - Phone:412-337-5961
Mailing Address - Fax:
Practice Address - Street 1:331 NEWMAN SPRINGS RD
Practice Address - Street 2:SUITE 143
Practice Address - City:RED BANK
Practice Address - State:NJ
Practice Address - Zip Code:07701-5688
Practice Address - Country:US
Practice Address - Phone:412-337-5961
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-02
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
923641133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered