Individual provider Active NPI

Antoinette Liviola, MS, CNS, LDN

  • Nutritionist
  • Riverhead, NY
National Provider Identifier
1124998836
Registry record updated Nov 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
License
DX5111 Issued in MD
Practice address
1087 Route 58 # 1077
Riverhead, NY 11901-2141
Phone
(631) 594-8021
Fax
(631) 594-7322
NPI assigned
Nov 7, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 7, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X 12805 NY
Nutritionist 133N00000X DX5111 MD Primary

Addresses

Primary practice location

1087 Route 58 # 1077
Riverhead, NY 11901-2141

Mailing address

1087 Route 58 # 1077
Riverhead, NY 11901-2141
Phone (631) 594-8021

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Certified Nurse Specialist, Master of Science

State licenses

LicenseStateTypeSpecialty
DX5111MDMDNutritionist
12805NYMDNutritionist

Practice roles

OrganizationSpecialtyStatusNew patients
Aliv Wellness Nutritionist CurrentSince Nov 9, 2025 Accepting new patients

Locations

1087 Route 58
#1077
Riverhead, NY 11901
Phone (631) 594-8021

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1762473600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762473600000",
    "number": "1124998836",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1087 ROUTE 58 # 1077",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012141",
            "telephone_number": "631-594-8021",
            "fax_number": "631-594-7322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1087 ROUTE 58 # 1077",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012141",
            "telephone_number": "631-594-8021",
            "fax_number": "631-594-7322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIVIOLA",
        "first_name": "ANTOINETTE",
        "credential": "MS, CNS, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-11-07",
        "last_updated": "2025-11-07",
        "certification_date": "2025-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "NY",
            "license": "12805",
            "primary": false
        },
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "MD",
            "license": "DX5111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverhead, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2025; 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.