Healthcare Provider Details

I. General information

NPI: 1427979483
Provider Name (Legal Business Name): BROOKE ALYSSA PEARSON MS, RDN, CLC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

63 HIGHVIEW RD
MONROE NY
10950-5243
US

IV. Provider business mailing address

63 HIGHVIEW RD
MONROE NY
10950-5243
US

V. Phone/Fax

Practice location:
  • Phone: 845-325-4769
  • Fax:
Mailing address:
  • Phone: 845-325-4769
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86389916
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: