1679875124 NPI NUMBER - NUTRITION FIRST LLC
Summary
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NPI Number |
1679875124 |
| Entity Type Code |
Organization |
| Provider Legal Name |
NUTRITION FIRST LLC |
| Provider Business Practice Location Address |
415 RTE 34 N
SUITE 107
COLTS NECK, NJ
ZIP 07722
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| Practice Location Phone Number |
(908) 692-4140 |
| Provider Taxonomy Code |
133V00000X - Dietitian, Registered |
| Specialization |
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| Provider Enumeration Date |
12/2/2010 |
| Last Update Date |
12/2/2010 |
NPI Number 1679875124 is assigned to an organization registered under the healthcare provider name NUTRITION FIRST LLC .
The provider is a SINGLE SPECIALTY GROUP .
The provider is physically located at:
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
Taxonomy Codes
The following information regarding the scope of practice of this provider is available:
| 1 |
133V00000X |
Dietitian, Registered |
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610878 |
NY |
View Code |
Other (Legacy) Identifiers
The following legacy identifiers for this provider are available:
NPI Record
| 1 |
NPI |
1679875124 |
| 2 |
Entity Type Code |
2 |
| 3 |
Employer Identification Number EIN |
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| 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: 5/14/2013
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.