Andrea N Anfuso Sisto, RDN
Individual provider Active NPI Registered Dietitian · Hackensack, NJ
NPI 1467587709 · NPPES record last updated Apr 8, 2025
Key facts
- NPI
- 1467587709
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Registered Dietitian 133V00000X
- License
- 838993
- Practice address
- 30 Prospect Ave
Wfan 3Rd Floor
Hackensack, NJ 07601-1915 - Phone
- (551) 996-5329
- Fax
- (551) 996-0115
- NPI assigned
- Feb 23, 2007
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NJ
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220422000552 | NJ | Practitioner - Registered Dietitian Or Nutrition Professional | 2567859523 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Hackensack Meridian Health Medical Group - Complex Care PC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 838993 | Yes |
Addresses
Primary practice location
30 Prospect Ave
Wfan 3Rd Floor
Hackensack, NJ 07601-1915
Mailing address
331 Newman Springs Road
BLDG. 2, Suite 220
Red Bank, NJ 07701
Phone (732) 807-0877
Other providers in Hackensack, NJ
- Diane Michelle Anderson
- Marques Anderson
- Andrew Fink M.D., P.C.
- Andrew H the, MD, LLC
- Jessica M Androsiglio
- Hanuman Kumar Angajala
- Angel Care
- Angel Touch Private Caregiver LLC
- Courtney Angeles
- Robert R Angels
All providers in Hackensack, NJ · Registered Dietitian in New Jersey
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 8, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.