Restore & Elevate Nutrition Corp

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

RESTORE & ELEVATE NUTRITION CORP

Practice address

49 Arizona Ave
Syosset, NY 11791-3101

Phone

(631) 809-8727

NPI assigned

Jan 30, 2023

Last updated

Jan 30, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Stephanie Coello, MS RD CDNNPI 1437811858

Title

Authorized Official

Phone

(631) 809-8727

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Stephanie Coello, MS RD CDN

  • Registered Dietitian
  • Syosset, NY
  • NPI 1437811858

  Dietitian, Registered

  NPD Authorized official

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

{
    "created_epoch": "1675036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675036800000",
    "number": "1861108284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "49 ARIZONA AVE",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117913101",
            "telephone_number": "631-809-8727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "49 ARIZONA AVE",
            "city": "SYOSSET",
            "state": "NY",
            "postal_code": "117913101",
            "telephone_number": "631-809-8727"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORE & ELEVATE NUTRITION CORP",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-30",
        "last_updated": "2023-01-30",
        "certification_date": "2023-01-28",
        "status": "A",
        "authorized_official_last_name": "COELLO",
        "authorized_official_first_name": "STEPHANIE",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "631-809-8727",
        "authorized_official_credential": "MS RD CDN"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Registered Dietitian in Syosset, NY
• Providers in Syosset, NY by specialty
• Registered Dietitian in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; 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.