Provider Demographics
NPI:1831438159
Name:NUTRITION FIRST, INC
Entity type:Organization
Organization Name:NUTRITION FIRST, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNEMARIE
Authorized Official - Middle Name:
Authorized Official - Last Name:NG
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RD, CDE, CDN
Authorized Official - Phone:631-751-3883
Mailing Address - Street 1:100 S JERSEY AVE
Mailing Address - Street 2:SUITE 14
Mailing Address - City:SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-2034
Mailing Address - Country:US
Mailing Address - Phone:631-751-3883
Mailing Address - Fax:631-751-3909
Practice Address - Street 1:100 S JERSEY AVE
Practice Address - Street 2:SUITE 14
Practice Address - City:SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-2034
Practice Address - Country:US
Practice Address - Phone:631-751-3883
Practice Address - Fax:631-751-3909
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-02-06
Last Update Date:2013-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005897133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty