Provider Demographics
NPI:1548918246
Name:ALYESH, LEAH (RD)
Entity type:Individual
Prefix:MRS
First Name:LEAH
Middle Name:
Last Name:ALYESH
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 BROOKHILL AVE
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08817-3404
Mailing Address - Country:US
Mailing Address - Phone:732-439-7614
Mailing Address - Fax:
Practice Address - Street 1:1105 E COUNTY LINE RD STE 212
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-2122
Practice Address - Country:US
Practice Address - Phone:732-302-8050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-13
Last Update Date:2022-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ1085624133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered