My Island Nutrition

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

MY ISLAND NUTRITION

Practice address

107 Sprucewood Dr
Levittown, NY 11756-3813

Phone

(516) 287-0364

NPI assigned

Mar 17, 2022

Organization subpart

No

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

Authorized official

Name

Bryan Stengel, RDN

Title

Dietitian

Phone

(516) 287-0364

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1647475200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657756800000",
    "number": "1255089264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "107 SPRUCEWOOD DR",
            "city": "LEVITTOWN",
            "state": "NY",
            "postal_code": "117563813",
            "telephone_number": "516-287-0364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "107 SPRUCEWOOD DR",
            "city": "LEVITTOWN",
            "state": "NY",
            "postal_code": "117563813",
            "telephone_number": "516-287-0364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MY ISLAND NUTRITION",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-03-17",
        "last_updated": "2022-07-14",
        "certification_date": "2022-07-14",
        "status": "A",
        "authorized_official_last_name": "STENGEL",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "DIETITIAN",
        "authorized_official_telephone_number": "516-287-0364",
        "authorized_official_credential": "RDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinic/Center in Levittown, NY
• Providers in Levittown, NY by specialty
• Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2022; 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.