Healthcare Provider Details

I. General information

NPI: 1699688069
Provider Name (Legal Business Name): ALISON HELLER RD, CSP, CDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALI HELLER RD, CSP, CDN

II. Dates (important events)

Enumeration Date: 09/25/2026
Last Update Date: 09/25/2026
Certification Date: 09/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

47 DIAMOND ST APT 1A
BROOKLYN NY
11222-7977
US

IV. Provider business mailing address

47 DIAMOND ST APT 1A
BROOKLYN NY
11222-7977
US

V. Phone/Fax

Practice location:
  • Phone: 954-593-2559
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86106148
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: