Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Tida Pradith Coralluzzo, RD

Individual provider Registered Dietitian · NPI 1073456422

Tida Pradith Coralluzzo, RD is a Registered Dietitian OR Nutrition Professional in Livingston, New Jersey. Qualified in 2021, 5 years ago. Licensed in New Jersey.

Years since qualifying
5
Licensed in
NJ
In the registry since
2026
What do these letters mean?
RD — Registered Dietitian
A credentialed nutrition professional.

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Practice location Address checks out

66 W Mount Pleasant Ave Ste 205
Livingston, NJ 07039-2930
Phone: (917) 837-0598
Fax: (973) 740-8932
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Dietitian (primary) Taxonomy 133V00000X · Licence 86010561 (NJ)

Record details

NPI number1073456422
Entity typeIndividual (Type 1)
GenderFemale
Credentials RD
Sole proprietorNo
NPI enumeratedApril 10, 2026
Last updated in NPPESApril 10, 2026
Certification dateApril 10, 2026
Mailing address66 W Mount Pleasant Ave Ste 205, Livingston, NJ 07039-2930

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyREGISTERED DIETITIAN OR NUTRITION PROFESSIONAL
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Accepts Medicare assignment Not indicated
Practice locations3 on file with Medicare

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