Provider Demographics
NPI:1407169311
Name:WEIGH OF LIFE USA
Entity Type:Organization
Organization Name:WEIGH OF LIFE USA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MBR
Authorized Official - Prefix:MS
Authorized Official - First Name:ROSEMARY
Authorized Official - Middle Name:SEPE
Authorized Official - Last Name:VIETS
Authorized Official - Suffix:
Authorized Official - Credentials:RD,CDN
Authorized Official - Phone:516-384-1096
Mailing Address - Street 1:2160 POE AVE
Mailing Address - Street 2:
Mailing Address - City:EAST MEADOW
Mailing Address - State:NY
Mailing Address - Zip Code:11554-5164
Mailing Address - Country:US
Mailing Address - Phone:516-384-1096
Mailing Address - Fax:
Practice Address - Street 1:2160 POE AVE
Practice Address - Street 2:
Practice Address - City:EAST MEADOW
Practice Address - State:NY
Practice Address - Zip Code:11554-5164
Practice Address - Country:US
Practice Address - Phone:516-384-1096
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-07-20
Last Update Date:2010-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty