Organization Active NPI

Therealisticdietitian LLC

  • Registered Dietitian
  • Mullica Hill, NJ
National Provider Identifier
1053102426
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
THEREALISTICDIETITIAN LLC
Practice address
107 Willow Oaks LN
Mullica Hill, NJ 08062-4535
Phone
(609) 280-9353
NPI assigned
May 15, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2025

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

Authorized official

Name
Sophia UrsinoNPI 1932815651
Title
Owner
Phone
(609) 280-9353

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X Primary

Addresses

Primary practice location

107 Willow Oaks LN
Mullica Hill, NJ 08062-4535

Mailing address

107 Willow Oaks LN
Mullica Hill, NJ 08062-4535

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1747267200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1747267200000",
    "number": "1053102426",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 WILLOW OAKS LN",
            "city": "MULLICA HILL",
            "state": "NJ",
            "postal_code": "080624535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 WILLOW OAKS LN",
            "city": "MULLICA HILL",
            "state": "NJ",
            "postal_code": "080624535",
            "telephone_number": "609-280-9353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THEREALISTICDIETITIAN LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-15",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A",
        "authorized_official_last_name": "URSINO",
        "authorized_official_first_name": "SOPHIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "609-280-9353"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mullica Hill, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2025; 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.