Provider Demographics
NPI:1609182393
Name:KEY NUTRITION LLC
Entity Type:Organization
Organization Name:KEY NUTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:MS
Authorized Official - First Name:OLENA
Authorized Official - Middle Name:
Authorized Official - Last Name:ZINSHTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:267-872-7113
Mailing Address - Street 1:713 SANSOM ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19106-3230
Mailing Address - Country:US
Mailing Address - Phone:267-872-7113
Mailing Address - Fax:
Practice Address - Street 1:713 SANSOM ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19106-3230
Practice Address - Country:US
Practice Address - Phone:267-872-7113
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-19
Last Update Date:2010-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN004321133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty