NPIMap

Organization Active NPI

Nutrition for Life Limited Liability Company

  • Registered Dietitian
  • Wyckoff, NJ
National Provider Identifier
1467739722
Registry record updated Nov 14, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
875535 Issued in IL
Legal business name
NUTRITION FOR LIFE LIMITED LIABILITY COMPANY
Practice address
446 Radcliffe St
Wyckoff, NJ 07481-3062
Phone
(201) 725-9179
NPI assigned
Nov 14, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2011

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

Authorized official

Name
Debra Grossano, RDNPI 1407885072
Title
Owner
Phone
(201) 725-9179

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 875535 IL Primary

Addresses

Primary practice location

446 Radcliffe St
Wyckoff, NJ 07481-3062

Mailing address

446 Radcliffe St
Wyckoff, NJ 07481-3062
Phone (201) 725-9179

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": "1321228800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1321228800000",
    "number": "1467739722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "446 RADCLIFFE ST",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074813062",
            "telephone_number": "201-725-9179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "446 RADCLIFFE ST",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074813062",
            "telephone_number": "201-725-9179"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NUTRITION FOR LIFE LIMITED LIABILITY COMPANY",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-11-14",
        "last_updated": "2011-11-14",
        "status": "A",
        "authorized_official_last_name": "GROSSANO",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "201-725-9179",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "IL",
            "license": "875535",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyckoff, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2011; 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.