Organization
NUTRIALL WELLNESS CENTER LLC
Active
Other names
NUTRIALL WELLNESS CENTER
Organization subpart
No
Provider details
NPI number
Authorized official
XIAOFANG TAN (REGISTERED DIETITIAN)
(929) 777-4933
Entity
Organization
Contact information
Practice address
3347 213TH ST, BAYSIDE, NY 11361-1560
(929) 777-4933
(888) 370-1981
Mailing address
3347 213TH ST, BAYSIDE, NY 11361-1560
(929) 777-4933
(888) 370-1981
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
133VN1004X
Pediatric Nutrition Registered Dietitian
—
—
Other
Enumeration date
09/13/2022
Last updated
05/09/2023
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