Active NPI
Empowered Beast Nutrition LLC
- Registered Dietitian
- Bay Shore, NY
National Provider Identifier
1790503472
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- Legal business name
- EMPOWERED BEAST NUTRITION LLC
- Practice address
- 1432 E Forks Rd
Bay Shore, NY 11706-4312 - Phone
- (646) 283-2868
- NPI assigned
- Oct 1, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Taiyyibah Moughal, RDN
- Title
- Owner
- Phone
- (646) 283-2868
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | Primary |
Addresses
Primary practice location
1432 E Forks Rd
Bay Shore, NY 11706-4312
Mailing address
1432 E Forks Rd
Bay Shore, NY 11706-4312
Phone (646) 283-2868
National Provider Directory
National Provider Directory- Tax ID family
- Empowered Beast Nutrition LLC
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Registered Dietitian
- Bay Shore, NY
- NPI 1528895372
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": "1727740800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1728864000000",
"number": "1790503472",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1432 E FORKS RD",
"city": "BAY SHORE",
"state": "NY",
"postal_code": "117064312",
"telephone_number": "646-283-2868"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1432 E FORKS RD",
"city": "BAY SHORE",
"state": "NY",
"postal_code": "117064312",
"telephone_number": "646-283-2868"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "EMPOWERED BEAST NUTRITION LLC",
"organizational_subpart": "NO",
"enumeration_date": "2024-10-01",
"last_updated": "2024-10-14",
"certification_date": "2024-10-14",
"status": "A",
"authorized_official_last_name": "MOUGHAL",
"authorized_official_first_name": "TAIYYIBAH",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "646-283-2868",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "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 Bay Shore, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.