Custom Nutrition, LLC

Primary specialty

Registered DietitianTaxonomy code 133V00000X

Legal business name

CUSTOM NUTRITION, LLC

Practice address

390 Plandome Rd
Manhasset, NY 11030-1917

Phone

(516) 200-4582

Fax

(646) 390-4255

NPI assigned

Sep 3, 2019

Last updated

Sep 3, 2019By 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

Luciana Pereira, RD

Title

Owner

Phone

(516) 200-4582

Specialties & licenses 1

Addresses

Electronic endpoints 1

Locations

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

{
    "created_epoch": "1567468800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1567468800000",
    "number": "1932757085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 PLANDOME RD",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110301917",
            "telephone_number": "516-200-4582",
            "fax_number": "646-390-4255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 PLANDOME RD",
            "city": "MANHASSET",
            "state": "NY",
            "postal_code": "110301917",
            "telephone_number": "516-200-4582",
            "fax_number": "646-390-4255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CUSTOM NUTRITION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-09-03",
        "last_updated": "2019-09-03",
        "status": "A",
        "authorized_official_last_name": "PEREIRA",
        "authorized_official_first_name": "LUCIANA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "516-200-4582",
        "authorized_official_credential": "RD"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dietitian, Registered",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lupereira@customnutrition.com",
            "affiliation": "N",
            "address_1": "390 Plandome Rd",
            "city": "Manhasset",
            "state": "NY",
            "country_code": "US",
            "postal_code": "110301917",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kevin J Cunningham, PA
• Michelle Marie Cuoco, NP
• Rhoda Curmi, RN
• Lisa Currie, LMSW
• Tennyson Curtis, CRNA
• Andrew Michael Cyr, MD
• Gina Cyriac, FNP
• Matthew Czaja
• Catherine A D'Agostino, MD
• Joseph C D'Angelo, AGACNP

• Registered Dietitian in Manhasset, NY
• Providers in Manhasset, 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 Sep 3, 2019; 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.