Provider Demographics
NPI:1265986426
Name:CUDJOE, ALYCE H (MA, RD, CDCES)
Entity type:Individual
Prefix:
First Name:ALYCE
Middle Name:H
Last Name:CUDJOE
Suffix:
Gender:F
Credentials:MA, RD, CDCES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 WATSON AVE
Mailing Address - Street 2:
Mailing Address - City:EAST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07018-3303
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3 FARRINGTON ST
Practice Address - Street 2:
Practice Address - City:VAUXHALL
Practice Address - State:NJ
Practice Address - Zip Code:07088-1307
Practice Address - Country:US
Practice Address - Phone:256-652-5641
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-05
Last Update Date:2021-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered