Provider Demographics
NPI:1750983995
Name:LGC NUTRITION LLC
Entity type:Organization
Organization Name:LGC NUTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LINDSEY
Authorized Official - Middle Name:G
Authorized Official - Last Name:CUMOLETTI
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:518-470-0866
Mailing Address - Street 1:679 NEW SALEM RD
Mailing Address - Street 2:
Mailing Address - City:VOORHEESVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12186-4832
Mailing Address - Country:US
Mailing Address - Phone:518-470-0866
Mailing Address - Fax:
Practice Address - Street 1:125 ADAMS ST
Practice Address - Street 2:
Practice Address - City:DELMAR
Practice Address - State:NY
Practice Address - Zip Code:12054-3211
Practice Address - Country:US
Practice Address - Phone:518-470-0866
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-12
Last Update Date:2020-11-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty