Healthcare Provider Details

I. General information

NPI: 1255833653
Provider Name (Legal Business Name): TRUTH & LIFE NUTRITION CONSULTANTS INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/02/2018
Last Update Date: 03/02/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

254 ROUTE 17K STE 203
NEWBURGH NY
12550-8300
US

IV. Provider business mailing address

8 RUE DE VIN DR
MARLBORO NY
12542-5953
US

V. Phone/Fax

Practice location:
  • Phone: 845-913-7737
  • Fax: 877-291-6044
Mailing address:
  • Phone:
  • 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: MS. PHYLLIS YOUNG
Title or Position: OWNER
Credential: PA-C
Phone: 845-913-7737