=====================================================
General NPI Number Information
=====================================================
NPI Number | 1255207809
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DIETITIAN INSIGHT NUTRITION SERVICES, PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 10/13/2025
-----------------------------------------------------
Last Update Date | 04/28/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 180 S MIDDLE NECK RD
-----------------------------------------------------
City | GREAT NECK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11021-4643
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 929-357-4324
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 180 S MIDDLE NECK RD APT 3P
-----------------------------------------------------
City | GREAT NECK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11021-4609
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 929-357-4324
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MICHELLE TAK YAN CHAU
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 650-215-8250
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 133V00000X
-----------------------------------------------------
Taxonomy Name | Registered Dietitian
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------