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NPI Code Detail

MEDICARE: LEANNA MARIE PISCETELLO RD

MEDICARE: LEANNA MARIE PISCETELLO RD
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
1133V00000XRegistered Dietitian86079083AZ
2133V00000XRegistered Dietitian86079083VA
3133V00000XRegistered Dietitian010263NY
4133V00000XRegistered Dietitian86079083CO
5133V00000XRegistered Dietitian86079083MI
6133V00000XRegistered Dietitian86079083NJ

General Provider Information

NPI Number : 1952267155
Entity Type Code : Individual
Provider Name (Legal Business Name) : LEANNA MARIE PISCETELLO RD
Provider Business Mailing Address
First Line : 220 OCEAN AVE APT 12
Second Line :
City : LONG BRANCH
State : NJ
Zip : 07740-6638
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 220 OCEAN AVE
Second Line :
City : LONG BRANCH
State : NJ
Zip : 07740-6667
Country : US
Telephone Number : 860-933-9463
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/31/2025
Last Update Date : 01/14/2026

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Directions to “ LEANNA MARIE PISCETELLO RD” Practice Location

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