NPIMap

Organization Active NPI

Pride Nutrition LLC

  • Registered Dietitian
  • West New York, NJ
National Provider Identifier
1467315929
Registry record updated Dec 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
Legal business name
PRIDE NUTRITION LLC
Practice address
431 62ND St Apt 305
West New York, NJ 07093-2430
Phone
(631) 942-0473
NPI assigned
Dec 3, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2025

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

Authorized official

Name
Paul Jaeckel, MS, RDNNPI 1609644673
Title
Owner
Phone
(631) 942-0473

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered DietitianGroup: 193400000X SINGLE SPECIALTY GROUP 133V00000X Primary

Addresses

Primary practice location

431 62ND St Apt 305
West New York, NJ 07093-2430

Mailing address

431 62ND St Apt 305
West New York, NJ 07093-2430

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1764720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764720000000",
    "number": "1467315929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 62ND ST APT 305",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070932430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "431 62ND ST APT 305",
            "city": "WEST NEW YORK",
            "state": "NJ",
            "postal_code": "070932430",
            "telephone_number": "631-942-0473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIDE NUTRITION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-03",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A",
        "authorized_official_last_name": "JAECKEL",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-942-0473",
        "authorized_official_credential": "MS, RDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West New York, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 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.