Individual provider Active NPI

Alison P Kucich

  • Nutrition Education Nutritionist
  • Fair Haven, NJ
National Provider Identifier
1043890767
Registry record updated Apr 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition Education NutritionistTaxonomy code 133NN1002X
Practice address
18 Woodland Dr S
Fair Haven, NJ 07704-3642
Phone
(917) 331-5665
NPI assigned
Apr 8, 2021
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 8, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Education NutritionistGroup: 193400000X SINGLE SPECIALTY GROUP 133NN1002X Primary

Addresses

Primary practice location

18 Woodland Dr S
Fair Haven, NJ 07704-3642

Mailing address

18 Woodland Dr S
Fair Haven, NJ 07704-3642
Phone (917) 331-5665

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1617840000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617840000000",
    "number": "1043890767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18 WOODLAND DR S",
            "city": "FAIR HAVEN",
            "state": "NJ",
            "postal_code": "077043642",
            "telephone_number": "917-331-5665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18 WOODLAND DR S",
            "city": "FAIR HAVEN",
            "state": "NJ",
            "postal_code": "077043642",
            "telephone_number": "917-331-5665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUCICH",
        "first_name": "ALISON",
        "middle_name": "P",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-04-08",
        "last_updated": "2021-04-08",
        "certification_date": "2021-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133NN1002X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nutritionist, Nutrition, Education",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Haven, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.