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General NPI Number Information
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NPI Number | 1043171838
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Entity Type | Organization
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Legal Business Name | NOURISHED AND WELL
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Dates
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Enumeration Date | 11/20/2025
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Last Update Date | 11/20/2025
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Provider Practice Location Address
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Address Line | 1130 OGLETOWN RD STE 2
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City | NEWARK
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State | DE
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Zip | 19711-5689
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Country | US
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Telephone | 646-854-2564
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Fax |
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Provider Business Mailing Address
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Address Line | 1130 OGLETOWN RD STE 2
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City | NEWARK
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State | DE
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Zip | 19711-5689
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DOMINIC M STEWART
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Credential | CNS, LDN
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Telephone | 646-854-2564
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133N00000X
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Taxonomy Name | Nutritionist
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License Number |
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License Number State |
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