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Organization

PROVIDENCE NUTRITION, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. NEIL BERANBAUM (MANAGER)
(401) 465-4222
Entity
Organization

Contact information

Practice address
439 BENEFIT ST UNIT 1, PROVIDENCE, RI 02903-2934
(401) 262-0841
Mailing address
439 BENEFIT ST UNIT 1, PROVIDENCE, RI 02903-2934
(401) 262-0841

Taxonomy

Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary

Other

Enumeration date
12/04/2017
Last updated
12/04/2017
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