Healthcare Provider Details

I. General information

NPI: 1073302154
Provider Name (Legal Business Name): SYNERGIA NUTRITION, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2025
Last Update Date: 05/05/2025
Certification Date: 05/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11 APEX DR
MARLBOROUGH MA
01752
US

IV. Provider business mailing address

PO BOX 634
WARNER NH
03278-0634
US

V. Phone/Fax

Practice location:
  • Phone: 631-488-0877
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133NN1002X
TaxonomyNutrition Education Nutritionist
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number
License Number State

VIII. Authorized Official

Name: NATALLLIA LAMBRECHT
Title or Position: MS, CNS, LDN
Credential:
Phone: 631-488-0877