Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Alyssa Rose Jacullo

Individual provider Registered Dietitian · NPI 1952124968

Alyssa Rose Jacullo is a Registered Dietitian in Bala Cynwyd, Pennsylvania. Practices as a sole proprietor and works from 2 locations. Licensed in Pennsylvania.

Licensed in
PA
In the registry since
2024
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Practice location Address checks out

1 Presidential Blvd
Bala Cynwyd, PA 19004-1017
Phone: (215) 264-2574
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 12430 Wyndom Rd, Philadelphia, PA 19154-1322 — (631) 943-1616

Specialties & licences

Registered Dietitian (primary) Taxonomy 133V00000X · Licence DN007895 (PA)

Record details

NPI number1952124968
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedNovember 7, 2024
Last updated in NPPESNovember 7, 2024
Certification dateNovember 7, 2024
Mailing address12430 Wyndom Rd, Philadelphia, PA 19154-1322

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