NUTRITION FIRST LLC - NPI NUMBER 1679875124

Summary

Provider Name: NUTRITION FIRST LLC

NPI Number: 1679875124

Clasification: Dietitian, Registered (133V00000X)

Address:
415 RTE 34 N
SUITE 107
COLTS NECK, NJ
ZIP 07722

Phone Number: (908) 692-4140



Detailed Information

NUTRITION FIRST LLC is a registered dietitian in Colts Neck, NJ. The provider is a registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor�s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. The assigned NPI number for this provider is 1679875124 and is registered as an organization entity type and is a single specialty group.

The provider's business address is:

415 RTE 34 N
SUITE 107
COLTS NECK, NJ
ZIP 07722-017
Phone: (908) 692-4140
Fax: (732) 946-1177

The provider's authorized official is Luanne Wright Petrie .
The authorized official title is Direct Owner and has the following contact phone number (908) 692-4140.

The enumeration date for this NPI number is 12/2/2010 and was last updated on 12/2/2010.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 133V00000X Dietitian, Registered 610878 NY Yes

NPI Record

No. Field Name Field Value
1 NPI 1679875124
2 Entity Type Code 2
3 Employer Identification Number EIN
4 Provider Organization Name Legal Business Name NUTRITION FIRST LLC
5 Provider First Line Business Practice Location Address 415 RTE 34 N
6 Provider Second Line Business Practice Location Address SUITE 107
7 Provider Business Practice Location Address City Name COLTS NECK
8 Provider Business Practice Location Address State Name NJ
9 Provider Business Practice Location Address Postal Code 077221017
10 Provider Business Practice Location Address Country Code If outside U S US
11 Provider Business Practice Location Address Telephone Number 9086924140
12 Provider Business Practice Location Address Fax Number 7329461177
13 Provider Enumeration Date 12/2/2010
14 Last Update Date 12/2/2010
15 Authorized Official Last Name PETRIE
16 Authorized Official First Name LUANNE
17 Authorized Official Middle Name WRIGHT
18 Authorized Official Title or Position DIRECT OWNER
19 Authorized Official Telephone Number 9086924140
20 Healthcare Provider Taxonomy Code 1 133V00000X
21 Provider License Number 1 610878
22 Provider License Number State Code 1 NY
23 Healthcare Provider Primary Taxonomy Switch 1 Y
24 Is Organization Subpart N
25 Authorized Official Name Prefix Text MRS.
26 Authorized Official Credential Text MS, RD, CDE
27 Healthcare Provider Taxonomy Group 1 193400000X SINGLE SPECIALTY GROUP

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This page was last updated on: 4/14/2014
All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.