Organization
EMPOWERED BEAST NUTRITION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAIYYIBAH MOUGHAL RDN (REGISTER DIETITIAN NUTRITIONIST)
(646) 243-2868
Entity
Organization
Contact information
Practice address
1432 E FORKS RD, BAY SHORE, NY 11706-4312
(646) 243-2868
Mailing address
1432 E FORKS RD, BAY SHORE, NY 11706-4312
(646) 243-2868
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
09/16/2024
Last updated
10/14/2024
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