=====================================================
General NPI Number Information
=====================================================
NPI Number | 1407646664
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ALEEYAH ADNAN RDN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/10/2025
-----------------------------------------------------
Last Update Date | 06/29/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 10708 N GAGE RD
-----------------------------------------------------
City | BARNEVELD
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 13304-2527
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 315-724-6907
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 411 EXPENSE ST
-----------------------------------------------------
City | ROME
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 13440-4032
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 315-334-2306
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 133V00000X
-----------------------------------------------------
Taxonomy Name | Registered Dietitian
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------