Provider Demographics
NPI:1144804659
Name:YOUR NUTRI GURU
Entity Type:Organization
Organization Name:YOUR NUTRI GURU
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JUHI
Authorized Official - Middle Name:
Authorized Official - Last Name:GUPTA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:860-783-4400
Mailing Address - Street 1:87 NATSISKY FARM RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH WINDSOR
Mailing Address - State:CT
Mailing Address - Zip Code:06074-1832
Mailing Address - Country:US
Mailing Address - Phone:860-783-4400
Mailing Address - Fax:860-783-4500
Practice Address - Street 1:87 NATSISKY FARM RD
Practice Address - Street 2:
Practice Address - City:SOUTH WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06074-1832
Practice Address - Country:US
Practice Address - Phone:860-783-4400
Practice Address - Fax:860-783-4500
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-05-11
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty