Live Wise Nutrition PLLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

0065861 Issued in NY

Legal business name

LIVE WISE NUTRITION PLLC

Practice address

16 Bay 8TH St
Brooklyn, NY 11228-3417

Phone

(347) 946-4245

NPI assigned

Jul 13, 2017

Organization subpart

No

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

Authorized official

Name

Cynthia WongNPI 1467699298

Title

Sole Proprietor

Phone

(347) 946-4245

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Cynthia Wong, RD, CDN

  • Registered Dietitian
  • Brooklyn, NY
  • NPI 1467699298
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1499904000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1235651027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 BAY 8TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112283417",
            "telephone_number": "347-946-4245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 BAY 8TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112283417",
            "telephone_number": "347-946-4245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVE WISE NUTRITION PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-07-13",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "WONG",
        "authorized_official_first_name": "CYNTHIA",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "347-946-4245"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": "NY",
            "license": "0065861",
            "primary": true
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• 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 Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.