Organization Active NPI

Lifeways Nutrition, PLLC

  • Nutritionist
  • New York, NY
National Provider Identifier
1871935254
Registry record updated Mar 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
License
002215 Issued in NY
Legal business name
LIFEWAYS NUTRITION, PLLC
Practice address
261 E 78TH St
6TH Floor
New York, NY 10075-1216
Phone
(646) 520-9751
NPI assigned
Jul 25, 2013
Last updated
Mar 1, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2016

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

Authorized official

Name
Ms. Deborah Ann Cardile, M.S., CDNNPI 1699035402
Title
Clinical Nutrition Manager
Phone
(646) 520-9751

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)CodeLicenseStatePrimary
NutritionistGroup: 193400000X SINGLE SPECIALTY GROUP 133N00000X 002215 NY Primary

Addresses

Primary practice location

261 E 78TH St
6TH Floor
New York, NY 10075-1216

Mailing address

170 E 89TH St
Suite 4E
New York, NY 10128-2311
Phone (646) 386-7745

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20140821000734 NY Part B Supplier - Clinic/Group Practice 9739307430 Receives reassigned benefits from 1 practitioner
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1374710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456790400000",
    "number": "1871935254",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 E 89TH ST",
            "address_2": "SUITE 4E",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "101282311",
            "telephone_number": "646-386-7745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 E 78TH ST",
            "address_2": "6TH FLOOR",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100751216",
            "telephone_number": "646-520-9751"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFEWAYS NUTRITION, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-25",
        "last_updated": "2016-03-01",
        "status": "A",
        "authorized_official_last_name": "CARDILE",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "ANN",
        "authorized_official_title_or_position": "CLINICAL NUTRITION MANAGER",
        "authorized_official_telephone_number": "646-520-9751",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "M.S., CDN"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nutritionist",
            "state": "NY",
            "license": "002215",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.