Tida Pradith Coralluzzo, RD

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

86010561 Issued in NJ

Practice address

66 W Mount Pleasant Ave Ste 205
Livingston, NJ 07039-2930

Phone

(917) 837-0598

Fax

(973) 740-8932

NPI assigned

Apr 10, 2026

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Tida Pradith Former name

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Specialty

Registered Dietitian Or Nutrition Professional

Education

Other, 2021

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Elysa Dinzes Nutrition LLC

  • Registered Dietitian
  • Livingston, NJ
  • NPI 1659903870
  Medicare reassignment

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

{
    "created_epoch": "1775779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775779200000",
    "number": "1073456422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "66 W MOUNT PLEASANT AVE STE 205",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070392930",
            "telephone_number": "917-837-0598",
            "fax_number": "973-740-8932"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "66 W MOUNT PLEASANT AVE STE 205",
            "city": "LIVINGSTON",
            "state": "NJ",
            "postal_code": "070392930",
            "telephone_number": "917-837-0598",
            "fax_number": "973-740-8932"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORALLUZZO",
        "first_name": "TIDA",
        "middle_name": "PRADITH",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-04-10",
        "last_updated": "2026-04-10",
        "certification_date": "2026-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NJ",
            "license": "86010561",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TIDA",
            "last_name": "PRADITH",
            "credential": "RD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Registered Dietitian in Livingston, NJ
• Providers in Livingston, NJ by specialty
• Registered Dietitian in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.