Organization Name: | NUTRITIOM FIRST |
NPI Number: | 1114128238 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | LUANNE WRIGHT PETRIE (REGISTERED DIETITIAN, DIABETES ED) |
Mailing Address: | 29 E Larchmont Dr Colts Neck |
State: | NJ US |
Postal Code: | 077221181 |
Phone Number: | 9086924140 |
Fax Number: | |
NPI Enumeration Date: | 05/29/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133NN1002X |
License Number: | 610878 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Nutritionist |
Taxonomy Specialization: | Nutrition, Education |
Taxonomy Definition: |