Providence Nutrition, LLC

Primary specialty

NutritionistTaxonomy code 133N00000X

Legal business name

PROVIDENCE NUTRITION, LLC

Practice address

439 Benefit St Unit 1
Providence, RI 02903-2934

Phone

(401) 262-0841

NPI assigned

Dec 4, 2017

Organization subpart

No

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

Authorized official

Name

Mr. Neil Beranbaum

Title

Manager

Phone

(401) 465-4222

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1512345600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1512345600000",
    "number": "1548775299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "439 BENEFIT ST UNIT 1",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029032934",
            "telephone_number": "401-262-0841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "439 BENEFIT ST UNIT 1",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029032934",
            "telephone_number": "401-262-0841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROVIDENCE NUTRITION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-04",
        "last_updated": "2017-12-04",
        "status": "A",
        "authorized_official_last_name": "BERANBAUM",
        "authorized_official_first_name": "NEIL",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "401-465-4222",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nutritionist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Providence Interventional Associates II LLC
• Providence Interventional Associates II LLC
• Providence Medical Healthcare Center
• Providence Medical Supplies
• Providence Metro Treatment Center
• Providence Orthodontics, LLC
• Providence Pediatrics
• Providence Perinatal Psychiatry
• Providence Physical Therapy Associates, Inc.
• Providence Prep Charter School

• Nutritionist in Providence, RI
• Providers in Providence, RI by specialty
• Nutritionist in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2017; 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.