Active NPI
Alyssa Marie Resnick
- Registered Dietitian
- Hoboken, NJ
National Provider Identifier
1982372512
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 1103803
- Practice address
- 417 Adams St Apt 3R
Hoboken, NJ 07030-2689 - Phone
- (908) 472-7120
- NPI assigned
- Aug 30, 2021
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | |||
| Registered Dietitian | 133V00000X | 1103803 | NJ | Primary |
Addresses
Primary practice location
417 Adams St Apt 3R
Hoboken, NJ 07030-2689
Mailing address
417 Adams St Apt 3R
Hoboken, NJ 07030-2689
Phone (908) 472-7120
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1103803 | NJ | MD | Registered Dietitian |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Nourish, Inc. | Dietitian, Registered | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1630281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1630281600000",
"number": "1982372512",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "417 ADAMS ST APT 3R",
"city": "HOBOKEN",
"state": "NJ",
"postal_code": "070302689",
"telephone_number": "908-472-7120"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "417 ADAMS ST APT 3R",
"city": "HOBOKEN",
"state": "NJ",
"postal_code": "070302689",
"telephone_number": "908-472-7120"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RESNICK",
"first_name": "ALYSSA",
"middle_name": "MARIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2021-08-30",
"last_updated": "2021-08-30",
"certification_date": "2021-08-30",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": null,
"license": null,
"primary": false
},
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NJ",
"license": "1103803",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Hoboken, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 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.