| Organization Name: | LIPID (AKA) |
| NPI Number: | 1023431988 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | CARYN NISTICO (PRESIDENT/CONSULTING REG DIETITIAN) |
| Mailing Address: | 153 Beverly Rd Huntington Station |
| State: | NY US |
| Postal Code: | 117464522 |
| Phone Number: | 6314251578 |
| Fax Number: | 6314251578 |
| NPI Enumeration Date: | 01/29/2014 |
| NPI Last Update Date: | 01/29/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 133NN1002X |
| License Number: | 002667-1 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Dietary & Nutritional Service Providers |
| Taxonomy Classification: | Nutritionist |
| Taxonomy Specialization: | Nutrition, Education |
| Taxonomy Definition: | |