| Organization Name: | NUTRAPY, LLC |
| NPI Number: | 1063809630 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JIMMY CHUNG DUONG (OWNER/CLINICIAN) |
| Mailing Address: | 412 Washington St (inside Norwell Athletic Center) Norwell |
| State: | MA US |
| Postal Code: | 020612056 |
| Phone Number: | 5086854033 |
| Fax Number: | |
| NPI Enumeration Date: | 04/22/2015 |
| NPI Last Update Date: | 04/22/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 302R00000X |
| License Number: | 9250 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Managed Care Organizations |
| Taxonomy Classification: | Health Maintenance Organization |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) A form of health insurance in which its members prepay a premium for the HMO |