Provider Demographics
NPI:1033918644
Name:EISER, ALLISSA (RDN, CDN)
Entity type:Individual
Prefix:
First Name:ALLISSA
Middle Name:
Last Name:EISER
Suffix:
Gender:F
Credentials:RDN, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 IOWA AVE
Mailing Address - Street 2:
Mailing Address - City:RENSSELAER
Mailing Address - State:NY
Mailing Address - Zip Code:12144-4562
Mailing Address - Country:US
Mailing Address - Phone:989-745-3452
Mailing Address - Fax:
Practice Address - Street 1:110 IOWA AVE
Practice Address - Street 2:
Practice Address - City:RENSSELAER
Practice Address - State:NY
Practice Address - Zip Code:12144-4562
Practice Address - Country:US
Practice Address - Phone:989-745-3452
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-08
Last Update Date:2025-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011244133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered