Provider Demographics
NPI:1275391807
Name:SHAMLIAN NUTRITION PLLC
Entity Type:Organization
Organization Name:SHAMLIAN NUTRITION PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:CATHERINE
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAMLIAN
Authorized Official - Suffix:
Authorized Official - Credentials:RD CDN
Authorized Official - Phone:315-430-5593
Mailing Address - Street 1:4240 LAFAYETTE ROAD
Mailing Address - Street 2:
Mailing Address - City:JAMESVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:13078-9770
Mailing Address - Country:US
Mailing Address - Phone:315-430-5593
Mailing Address - Fax:
Practice Address - Street 1:4240 LAFAYETTE ROAD
Practice Address - Street 2:
Practice Address - City:JAMESVILLE
Practice Address - State:NY
Practice Address - Zip Code:13078-9770
Practice Address - Country:US
Practice Address - Phone:315-430-5593
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-08
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
No251J00000XAgenciesNursing Care
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No282E00000XHospitalsLong Term Care Hospital