My Fruitful Body Nutrition PLLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

MY FRUITFUL BODY NUTRITION PLLC

Practice address

142 Princess St
Hicksville, NY 11801-1100

Phone

(516) 592-2974

NPI assigned

Sep 20, 2021

Organization subpart

No

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

Authorized official

Name

Angela Houlie, MS, RDN, CDNNPI 1033780606

Title

Owner

Phone

(516) 592-2974

Specialties & licenses 1

Addresses

Electronic endpoints 1

Practitioners 1

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

• Angela Houlie, RDN, CDN

  • Registered Dietitian
  • Hicksville, NY
  • NPI 1033780606

  Dietitian, Registered

  NPD Authorized official

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

{
    "created_epoch": "1632096000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632096000000",
    "number": "1285304204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 PRINCESS ST",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118011100",
            "telephone_number": "516-592-2974"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 PRINCESS ST",
            "city": "HICKSVILLE",
            "state": "NY",
            "postal_code": "118011100",
            "telephone_number": "516-592-2974"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "330 W 77th St Apt 2B",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100246850",
            "country_code": "US",
            "telephone_number": "516-592-2974",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MY FRUITFUL BODY NUTRITION PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-20",
        "last_updated": "2021-09-20",
        "certification_date": "2021-09-20",
        "status": "A",
        "authorized_official_last_name": "HOULIE",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-592-2974",
        "authorized_official_credential": "MS, RDN, CDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://secure.gethealthie.com/",
            "affiliation": "N",
            "endpointDescription": "HIPAA Compliant Electronic Health Record",
            "address_1": "142 Princess St",
            "city": "Hicksville",
            "state": "NY",
            "country_code": "US",
            "postal_code": "118011100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Registered Dietitian in Hicksville, NY
• Providers in Hicksville, 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 Sep 20, 2021; 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.