Organization
APPLE WELLNESS AND NUTRITION CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHOBHA NANDIVADA RD (OWNER)
(347) 982-4372
Entity
Organization
Contact information
Practice address
113 FIELDSTONE RD, STATEN ISLAND, NY 10314-3275
(347) 982-4372
Mailing address
113 FIELDSTONE RD, STATEN ISLAND, NY 10314-3275
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1811211550
TYPE 1 NPI
NY
Enumeration date
10/25/2018
Last updated
10/25/2018
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