Ahava Nutrition LLC
Organization Active NPI Registered Dietitian · Waltham, MA
NPI 1649988932 · NPPES record last updated Jul 5, 2025
Key facts
- NPI
- 1649988932
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Registered Dietitian 133V00000X
- Legal business name
- AHAVA NUTRITION LLC
- Practice address
- 419 Moody St. Suite 1
Waltham, MA 02453 - Phone
- (617) 396-7349
- NPI assigned
- Nov 7, 2022
- Organization subpart
- No
Authorized official
- Name
- Stephanie Haber
- Title
- Owner
- Phone
- (949) 300-7187
Practitioners 1
-
Stephanie Haber, RD LDN
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20250114002926 | MA | Part B Supplier - Clinic/Group Practice | 6305374661 |
Receives reassigned benefits from 1 practitioner Practice locations: Lexington, MA |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian |
133V00000X | Yes |
Addresses
Primary practice location
419 Moody St. Suite 1
Waltham, MA 02453
Mailing address
405 Waltham St Ste 317
Lexington, MA 02421-7934
Phone (617) 396-7349
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All providers in Waltham, MA · Registered Dietitian in Massachusetts
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 5, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.