Provider Demographics
NPI:1457834939
Name:EAT TO LIVE NUTRITION
Entity Type:Organization
Organization Name:EAT TO LIVE NUTRITION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:MS
Authorized Official - First Name:MAISIE
Authorized Official - Middle Name:
Authorized Official - Last Name:OSTRYE
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:617-448-9817
Mailing Address - Street 1:8 WESTVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-4711
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:8 WESTVIEW AVE
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-4711
Practice Address - Country:US
Practice Address - Phone:617-448-9817
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-11
Last Update Date:2018-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty