Lynn P Hillery/Live Well With Lynn

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

006087-1 Issued in NY

Legal business name

LYNN P HILLERY/LIVE WELL WITH LYNN

Practice address

76 Southaven Ave
Ste 2
Medford, NY 11763-3745

Phone

(631) 343-2024

Fax

(631) 343-2024

NPI assigned

Jun 7, 2010

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Lynn P Hillery, RD

Title

Owner

Phone

(631) 921-1100

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1275868800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1275868800000",
    "number": "1124348610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 ANDREA LN",
            "city": "WEST SAYVILLE",
            "state": "NY",
            "postal_code": "117961515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "76 SOUTHAVEN AVE",
            "address_2": "STE 2",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117633745",
            "telephone_number": "631-343-2024",
            "fax_number": "631-343-2024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LYNN P HILLERY/LIVE WELL WITH LYNN",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-06-07",
        "last_updated": "2010-06-07",
        "status": "A",
        "authorized_official_last_name": "HILLERY",
        "authorized_official_first_name": "LYNN",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-921-1100",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "006087-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maria J Lopez Serrano, LPN
• Erica Marie Lopez, RDH
• Michael Lopez
• Courtney Lugaro
• Ellen Lynch
• Elisa Sue Macchia, MASTERS
• Aiesha Mackbennett
• Jennifer Mackey, DDS
• Nicole A Madonia
• Lynn R Maggiacomo

• Registered Dietitian in Medford, NY
• Providers in Medford, NY by specialty
• Registered Dietitian in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.