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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

NUTRISOURCE INC

Active Organization

NUTRISOURCE INC is a Metabolic Nutrition organization located in GREAT NECK, New York. NPI 1588857858 is currently active in the NPPES registry. Verify at CMS.

Metabolic Nutrition · GREAT NECK, NY

Registration Details

NPI Number
1588857858
Provider Type
Organization
NPI Issued
Aug 21, 2007 (19.022062042012 yrs)
Last Updated
Nov 22, 2011
License
005258 (NY)

Practice Information

Address
295 NORTHERN BLVD
SUITE 105
GREAT NECK, NY, 110214706
Browse NY providers · Browse ZIP 11021
Phone
5164823100
Fax
5164823131
Primary Specialty
Metabolic Nutrition
133VN1006X
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.