Provider Demographics
NPI:1689157133
Name:LIGHT HEALTH CONSULTING
Entity Type:Organization
Organization Name:LIGHT HEALTH CONSULTING
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:OLEG
Authorized Official - Middle Name:
Authorized Official - Last Name:YANKELEVICH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:347-733-2770
Mailing Address - Street 1:460 NEPTUNE AVE APT 19R
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11224-4326
Mailing Address - Country:US
Mailing Address - Phone:347-733-2770
Mailing Address - Fax:
Practice Address - Street 1:460 NEPTUNE AVE APT 19R
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11224-4326
Practice Address - Country:US
Practice Address - Phone:347-733-2770
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 - Multi-Specialty
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, EducationGroup - Multi-Specialty