Healthcare Provider Details

I. General information

NPI: 1205373529
Provider Name (Legal Business Name): LINDSAY WENGLER MS, RD, CDN, CNSC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2017
Last Update Date: 04/04/2026
Certification Date: 04/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 MARINE AVE
BROOKLYN NY
11209-7205
US

IV. Provider business mailing address

PO BOX 90021
BROOKLYN NY
11209-0021
US

V. Phone/Fax

Practice location:
  • Phone: 646-801-8789
  • Fax:
Mailing address:
  • Phone: 646-801-8789
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number008847
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number008847
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number008847
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number86053035
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: