Healthcare Provider Details

I. General information

NPI: 1326800228
Provider Name (Legal Business Name): WISE BITES NUTRITION PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/25/2024
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

136 BAKER HILL RD
GREAT NECK NY
11023-1716
US

IV. Provider business mailing address

136 BAKER HILL RD
GREAT NECK NY
11023-1716
US

V. Phone/Fax

Practice location:
  • Phone: 347-770-2462
  • Fax:
Mailing address:
  • Phone: 516-229-1162
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: BINA GOYKADOSH
Title or Position: OWNER
Credential: MS, RDN, CDN
Phone: 347-770-2462