Provider Demographics
NPI:1669287793
Name:JIANG NUTRITION LLC
Entity type:Organization
Organization Name:JIANG NUTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:QIANZHI
Authorized Official - Middle Name:
Authorized Official - Last Name:JIANG
Authorized Official - Suffix:
Authorized Official - Credentials:PHD, RDN, LDN
Authorized Official - Phone:315-708-7039
Mailing Address - Street 1:28 CENTRE ST
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-1804
Mailing Address - Country:US
Mailing Address - Phone:315-708-7039
Mailing Address - Fax:
Practice Address - Street 1:28 CENTRE ST
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-1804
Practice Address - Country:US
Practice Address - Phone:315-708-7039
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty