Provider Demographics
NPI:1396483574
Name:NEW ENGLAND NUTRITION & EXERCISE PLLC
Entity type:Organization
Organization Name:NEW ENGLAND NUTRITION & EXERCISE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:RD/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BRIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:BRUINOOGE
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:603-897-9340
Mailing Address - Street 1:230 LAFAYETTE RD STE 13
Mailing Address - Street 2:
Mailing Address - City:PORTSMOUTH
Mailing Address - State:NH
Mailing Address - Zip Code:03801-5465
Mailing Address - Country:US
Mailing Address - Phone:603-897-9340
Mailing Address - Fax:877-320-9707
Practice Address - Street 1:230 LAFAYETTE RD STE 13
Practice Address - Street 2:
Practice Address - City:PORTSMOUTH
Practice Address - State:NH
Practice Address - Zip Code:03801-5465
Practice Address - Country:US
Practice Address - Phone:603-897-9340
Practice Address - Fax:877-320-9707
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH86092789OtherCDR