Healthcare Provider Details

I. General information

NPI: 1972825347
Provider Name (Legal Business Name): LIFE FOCUS NUTRITION LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2010
Last Update Date: 02/13/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21 CRAIG CT
STAMFORD CT
06903-1427
US

IV. Provider business mailing address

21 CRAIG CT
STAMFORD CT
06903-1427
US

V. Phone/Fax

Practice location:
  • Phone: 203-321-8454
  • Fax: 866-293-4500
Mailing address:
  • Phone: 203-321-8454
  • Fax: 866-293-4500

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number000920
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number0047771
License Number StateNY

VIII. Authorized Official

Name: LINDA ARPINO
Title or Position: PRESIDENT
Credential: MA,RD,CDN
Phone: 203-321-8454