Provider Demographics
NPI:1861051393
Name:CASCONE, ALEXIS (MS, RD, CD-N)
Entity type:Individual
Prefix:
First Name:ALEXIS
Middle Name:
Last Name:CASCONE
Suffix:
Gender:F
Credentials:MS, RD, CD-N
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 E MAIN ST STE 211
Mailing Address - Street 2:
Mailing Address - City:AVON
Mailing Address - State:CT
Mailing Address - Zip Code:06001-3845
Mailing Address - Country:US
Mailing Address - Phone:860-245-8259
Mailing Address - Fax:
Practice Address - Street 1:35 E MAIN ST STE 211
Practice Address - Street 2:
Practice Address - City:AVON
Practice Address - State:CT
Practice Address - Zip Code:06001-3845
Practice Address - Country:US
Practice Address - Phone:860-221-8889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-06-09
Last Update Date:2023-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1558133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered