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General NPI Number Information
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NPI Number | 1639032600
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Entity Type | Individual
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Provider Name | ALYSSA MYER RD
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Gender | Female
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Dates
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Enumeration Date | 12/06/2025
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Last Update Date | 12/06/2025
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Provider Practice Location Address
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Address Line | 1326 NEW SENECA TPKE
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City | SKANEATELES
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State | NY
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Zip | 13152-8888
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Country | US
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Telephone | 315-710-0080
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Fax |
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Provider Business Mailing Address
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Address Line | 109 E IRVIN AVE APT 2
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City | STATE COLLEGE
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State | PA
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Zip | 16801-6162
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | 86301213
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License Number State |
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