Fully Functional Nutrition LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

FULLY FUNCTIONAL NUTRITION LLC

Practice address

1419 E 9TH St
Brooklyn, NY 11230-6459

Phone

(732) 710-7915

NPI assigned

Apr 3, 2023

Last updated

Aug 9, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dalia Harush, MS RDNPI 1619670726

Title

Ceo

Phone

(732) 710-7915

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Dalia Harush, RDN

  • Obesity and Weight Management Nutrition Registered Dietitian
  • Brooklyn, NY
  • NPI 1619670726
  Authorized official Same address or phone

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

{
    "created_epoch": "1680480000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723161600000",
    "number": "1184329088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1419 E 9TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112306459",
            "telephone_number": "732-710-7915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1419 E 9TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112306459",
            "telephone_number": "732-710-7915"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULLY FUNCTIONAL NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-03",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A",
        "authorized_official_last_name": "HARUSH",
        "authorized_official_first_name": "DALIA",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "732-710-7915",
        "authorized_official_credential": "MS RD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda Kay Fuller, NP
• Zohar Fuller
• Desere Fullerton, RN
• Victoria Anne Fullerton, OTR/L
• Jessie Colter Fullmer, MD
• Fully Functional Nutrition Wellness PLLC
• Samuil Fulman, PA
• Mychailo Fulmes, M.D., PH.D.
• Anthony Fulmore
• Christina Fulmore, LMSW

• Registered Dietitian in Brooklyn, NY
• Providers in Brooklyn, 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 Aug 9, 2024; 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.