MEDICARE: LEG UP NUTRITION, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1265112817
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LEG UP NUTRITION, LLC

Provider Business Mailing Address
First Line	:	203 WASHINGTON ST APT 166
Second Line	:
City	:	SALEM
State	:	MA
Zip	:	01970-3607
Country	:	US
Telephone Number	:	978-712-0772
Fax Number	:

Provider Business Practice Location Address
First Line	:	203 WASHINGTON ST APT 166
Second Line	:
City	:	SALEM
State	:	MA
Zip	:	01970-3607
Country	:	US
Telephone Number	:	978-712-0772
Fax Number	:

Authorized Official
Title or Position	:	OWNER, REGISTERED DIETITIAN
Name	:	ALLEGRA EGIZI
Credential	:	MS, RD, LDN
Telephone Number	:	978-712-0772

Provider Enumeration Date	:	07/19/2023
Last Update Date	:	07/19/2023

Similar Medicare Providers

1780114702 — LIVING WELL AFFILIATED HEALTH PROFESSIONALS, INC
Practice Location Address:

207 WASHINGTON ST
SALEM, MA
01970-3607

Practice Phone: 978-740-9355
Practice Fax:

1356643464 — MS. ANGELA L. BLACKMAN C.N.A.
Practice Location Address:

4653 LEE ROAD 379
SALEM, AL
36874-3607

Practice Phone: 334-291-7629
Practice Fax: 334-297-8711

1700595444 — DEBORAH LEE SUMRALL CPNP-AC
Practice Location Address:

1 MEDICAL CENTER BLVD
WINSTON SALEM, NC
27157-3607

Practice Phone: 336-713-4500
Practice Fax:

1962334326 — KATHLEEN MALONEY PA-C
Practice Location Address:

12 LIGHTNING LN
SALEM, MA
01970-6825

Practice Phone: 508-902-7283
Practice Fax:

1740113497 — CAITLYN SOUTHWORTH
Practice Location Address:

35 CONGRESS ST
SALEM, MA
01970-5529

Practice Phone: 978-225-0555
Practice Fax:

1346672698 — ISAIDA ROSIBEL HERNANDEZ
Practice Location Address:

27 CONGRESS ST
SALEM, MA
01970-7309

Practice Phone: 978-744-8388
Practice Fax:

Directions to “LEG UP NUTRITION, LLC ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.