NUTRISOURCE INC (NPI# 1588857858) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1588857858 |
| Entity Type | Organization |
| Organization Name | NUTRISOURCE INC |
| Practice Address |
295 Northern Blvd Suite 105 Great Neck NY 11021-4706 |
| Practice Telephone | 5164823100 |
| Practice Fax Number | 5164823131 |
| Mailing Telephone | 5164823100 |
| Mailing Fax Number | 5164823131 |
| Enumeration Date | 2007-08-21 |
| Last Update Date | 2011-11-22 |
| Authorized Official Name | MS. NICOLETTE M. PACE (PRESIDENT MANAGING DIRECTOR) |
| Authorized Official Telephone | 5164823100 |
| Authorized Official Credential | MS RD CDE CDN CF |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 133VN1006X |
Dietitian, Registered Specialization: Nutrition, Metabolic |
005258 | NY | Dietary & Nutritional Service Providers |
| Street Address |
295 NORTHERN BLVD SUITE 105 |
| City | GREAT NECK |
| State | NY |
| Zip Code | 11021-4706 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417928821 | Nicolette M Pace | Dietitian, Registered | 295 Northern Blvd, Ste 105, Great Neck, NY 11021-4706 | 2006-02-01 |
| 1467765685 | Frederic Rakowitz, M.d., Ph.d., PC | Internal Medicine | 295 Northern Blvd, Suite 208, Great Neck, NY 11021-4701 | 2010-07-16 |
| 1265759245 | Almas Nazir | Psychiatry & Neurology | 295 Northern Blvd, Suite 304, Great Neck, NY 11021-4706 | 2010-04-29 |
| 1487856399 | Yongshun Bei | Acupuncturist | 295 Northern Blvd, Suite 103, Great Neck, NY 11021-4701 | 2007-06-03 |
| 1477755387 | Xiaoling Fang | Acupuncturist | 295 Northern Blvd, Suite 103, Great Neck, NY 11021-4701 | 2007-06-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760097927 | Vital Balance Osteopathy, Pllc | Psychiatry & Neurology | 10 Bond Street, Ste 1, #290, Great Neck, NY 11021 | 2020-09-14 |
| 1770131922 | Bond Orthodontics & Dental Care Pllc | Dentist | 12 Bond Street., Suite#c4, Great Neck, NY 11021 | 2019-08-30 |
| 1295393858 | Ctrip.nyc, Inc. | Emergency Response System Companies | 3 Grace Ave, Suite 106, Great Neck, NY 11021 | 2019-05-30 |
| 1366929267 | Vishva Vajra Acupuncture PC | Acupuncturist | 23a Middle Neck Road, Great Neck, NY 11021 | 2018-07-24 |
| 1518457530 | Assured Quality Home Care, Inc. | In Home Supportive Care | 885 Northern Blvd., Greak Neck, NY 11021 | 2018-05-15 |
| 1881183275 | Liat Mindy Brody | Occupational Therapist | 7 Hickory Dr, Great Neck, NY 11021 | 2018-05-01 |
| 1457853707 | Allison Squillace | Social Worker | 7 Bond Suite 1a, Great Neck, NY 11021 | 2018-03-02 |
| 1275042855 | Seolhee Kang | Acupuncturist | 26 Linden Street, Apt 4c, Great Neck, NY 11021 | 2017-09-26 |
| 1346781598 | Sara Dreiblatt | Speech-Language Pathologist | 211-45 46th Road, Queens, NY 11021 | 2017-03-20 |
| 1962853416 | Darron Yelling Do, PC | Surgery | 305 Northen Blvd, 105, Great Neck, NY 11021 | 2016-06-27 |
| Find all providers in zip 11021 | ||||
| Taxonomy Code | 133VN1006X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| Specialization | Nutrition, Metabolic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114286887 | Ilene Frischer | Dietitian, Registered | 560 Northern Blvd Suite207, Great Neck, NY 11021 | 2012-05-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891308276 | Jennifer Nicole Arnette | Dietitian, Registered | 1207 Delaware Ave Ste 114, Buffalo, NY 14209-1458 | 2020-08-26 |
| 1487200358 | Jackie Carlson, Rd, Ldn, Cde Diabetes Consultant, LLC | Dietitian, Registered | 4867 College St, Ashville, NY 14710-9603 | 2019-08-15 |
| 1093219586 | Nutrition Link Services, LLC | Dietitian, Registered | 50 Jeanne Dr, Newburgh, NY 12550-1701 | 2018-03-20 |
| 1275037749 | Jo Ann Brown | Dietitian, Registered | 2233 Caton Ave Apt 6a, Brooklyn, NY 11226-2588 | 2018-03-20 |
| 1881101954 | Western New York Integrated Care Collaborative, Inc. | Dietitian, Registered | 742 Delaware Avenue, Buffalo, NY 14209 | 2018-01-10 |
| 1770994741 | Juliana Martinez | Dietitian, Registered | 430 West 34th St, Apt. 3k, New York, NY 10001-2310 | 2014-05-13 |
| 1912338120 | Kelly Elaine Gumpel | Dietitian, Registered | 60 Paulding Ave, Tarrytown, NY 10591-5713 | 2013-12-13 |
| 1467898528 | Ilona Ginevic | Dietitian, Registered | One Gustave L. Levy Place, Box 1497, New York, NY 10029 | 2013-05-16 |
| 1033492582 | His Rhema Nutrition Services, LLC | Dietitian, Registered | 9050 Parsons Blvd Ste 304, Jamaica, NY 11432-6052 | 2011-09-21 |
| 1225311970 | Judith Irene Aries | Dietitian, Registered | 24 Beech Rd, Islip, NY 11751-4907 | 2011-09-20 |
| Find all providers with the same taxonomy | ||||
| City | GREAT NECK |
| Zip Code | 11021 |
Please comment or provide details below to improve the information on NUTRISOURCE INC.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.