Tida Pradith Coralluzzo, RD
NPI 1073456422ActiveIndividual· Dietitian, Registered· Livingston, NJ
Dietitian, Registered (RD) in Livingston, New Jersey, licensed in NJ, with an NPI issued in April 2026. Enrolled in Medicare as practitioner - registered dietitian or nutrition professional.
Overview
| NPI | 1073456422 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | RD |
| Sole proprietor | No |
| NPI issued | Apr 10, 2026 |
| Last updated in NPPES | Apr 10, 2026 |
| Certified by provider | Apr 10, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dietitian, Registered Primary | 133V00000X | 86010561 | NJ |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Registered Dietitian Or Nutrition Professional (NJ) |
|---|
Education and affiliations
| Graduation year | 2021 |
|---|---|
| Medicare specialty | Registered Dietitian Or Nutrition Professional |
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All 29 registered dietitians in Livingston · All registered dietitians in New Jersey