Provider Demographics
NPI:1861032377
Name:PRO NUTRITION COUNSELING PLLC
Entity Type:Organization
Organization Name:PRO NUTRITION COUNSELING PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ASAL
Authorized Official - Middle Name:
Authorized Official - Last Name:HAKIM
Authorized Official - Suffix:
Authorized Official - Credentials:RD CDN CPT
Authorized Official - Phone:516-260-1202
Mailing Address - Street 1:16 JOHN BEAN CT
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-4628
Mailing Address - Country:US
Mailing Address - Phone:516-260-1202
Mailing Address - Fax:516-686-9526
Practice Address - Street 1:585 STEWART AVE SUITE LL-18
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530
Practice Address - Country:US
Practice Address - Phone:516-260-1202
Practice Address - Fax:516-686-9526
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-01-13
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty