Allisa Marie Risebrow

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

011123 Issued in NY

Practice address

79 Middleville Rd
Northport, NY 11768-2296

Phone

(631) 261-4400

NPI assigned

Nov 3, 2023

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1698969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698969600000",
    "number": "1811760507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1B MAKAMAH BEACH RD",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117681338",
            "telephone_number": "516-971-7967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "79 MIDDLEVILLE RD",
            "city": "NORTHPORT",
            "state": "NY",
            "postal_code": "117682296",
            "telephone_number": "631-261-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RISEBROW",
        "first_name": "ALLISA",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-11-03",
        "last_updated": "2023-11-03",
        "certification_date": "2023-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "011123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Richard P. Boughal, M.D., P.C.
• Edward James Richards
• Jean Frances Richards, RD
• Nicole Marie Richichi, MSW
• Martha V Ringen, M.S. LSP
• Lauren B. Risoli, LCSW-R
• Andrew J Rochman, MD
• Nancy Lee Rocks, R.PH.
• Kim H Rodriguez, PH.D., LMHC
• Margaret M Rogan, RD

• Registered Dietitian in Northport, NY
• Providers in Northport, NY by specialty
• Registered Dietitian in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2023; 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.