Sid III,LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

License

DN005313 Issued in PA

Legal business name

SID III,LLC

Practice address

545 N Route 73
West Berlin, NJ 08091-9242

Phone

(856) 753-1800

Fax

(856) 753-6200

NPI assigned

Oct 21, 2016

Organization subpart

No

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

Authorized official

Name

Beryl F Krinsky, RDN, LDN

Title

Registered Dietitian

Phone

(215) 764-9651

Specialties & licenses 1

Addresses

Other names 1

• Future Fitness Centers Doing business as

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

{
    "created_epoch": "1477008000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477008000000",
    "number": "1508317801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 18",
            "city": "WEST BERLIN",
            "state": "NJ",
            "postal_code": "08091",
            "telephone_number": "856-753-1800",
            "fax_number": "856-753-6200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 N ROUTE 73",
            "city": "WEST BERLIN",
            "state": "NJ",
            "postal_code": "080919242",
            "telephone_number": "856-753-1800",
            "fax_number": "856-753-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SID III,LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-21",
        "last_updated": "2016-10-21",
        "status": "A",
        "authorized_official_last_name": "KRINSKY",
        "authorized_official_first_name": "BERYL",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "REGISTERED DIETITIAN",
        "authorized_official_telephone_number": "215-764-9651",
        "authorized_official_credential": "RDN, LDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": "PA",
            "license": "DN005313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Future Fitness Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Registered Dietitian in West Berlin, NJ
• Providers in West Berlin, NJ by specialty
• Registered Dietitian in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 2016; 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.