Individual
ALLISA MARIE RISEBROW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
79 MIDDLEVILLE RD, NORTHPORT, NY 11768-2296
(631) 261-4400
Mailing address
1B MAKAMAH BEACH RD, NORTHPORT, NY 11768-1338
(516) 971-7967
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
011123
NY
Other
Enumeration date
11/03/2023
Last updated
11/03/2023
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