Provider Demographics
NPI:1053678144
Name:NUTRITION SOLUTIONS INC
Entity Type:Organization
Organization Name:NUTRITION SOLUTIONS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:RUSANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BOROCHOWA
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:718-850-6345
Mailing Address - Street 1:13876 QUEENS BLVD
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:BRIARWOOD
Mailing Address - State:NY
Mailing Address - Zip Code:11435-2930
Mailing Address - Country:US
Mailing Address - Phone:718-850-6345
Mailing Address - Fax:718-559-4895
Practice Address - Street 1:6933 170TH ST
Practice Address - Street 2:
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11365-3309
Practice Address - Country:US
Practice Address - Phone:718-850-6345
Practice Address - Fax:718-559-4895
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-13
Last Update Date:2012-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty