Provider Demographics
NPI:1821699455
Name:AVOTRITION LLC
Entity Type:Organization
Organization Name:AVOTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FOUNDER/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DEMSINA
Authorized Official - Middle Name:
Authorized Official - Last Name:BABAZADEH
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:209-620-3071
Mailing Address - Street 1:449 CANAL ST APT 606
Mailing Address - Street 2:
Mailing Address - City:SOMERVILLE
Mailing Address - State:MA
Mailing Address - Zip Code:02145-4364
Mailing Address - Country:US
Mailing Address - Phone:209-620-3071
Mailing Address - Fax:
Practice Address - Street 1:449 CANAL ST APT 606
Practice Address - Street 2:
Practice Address - City:SOMERVILLE
Practice Address - State:MA
Practice Address - Zip Code:02145-4364
Practice Address - Country:US
Practice Address - Phone:209-620-3071
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-02
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight ManagementGroup - Multi-Specialty
No133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, RenalGroup - Multi-Specialty
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, MetabolicGroup - Multi-Specialty