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General NPI Number Information
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NPI Number | 1346112125
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Entity Type | Organization
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Legal Business Name | WELL WITHIN NUTRITION
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Dates
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Enumeration Date | 09/22/2025
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Last Update Date | 09/22/2025
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Provider Practice Location Address
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Address Line | 60 FIRE ISLAND AVE STE 102
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City | BABYLON
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State | NY
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Zip | 11702-3502
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Country | US
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Telephone | 516-817-9581
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Fax |
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Provider Business Mailing Address
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Address Line | 58 HONEYSUCKLE RD
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City | LEVITTOWN
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State | NY
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Zip | 11756-2237
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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 | CLINICAL NUTRITIONIST
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Name | JACLYN ROSEN
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Credential | MS, CNS, CDN
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Telephone | 516-817-9581
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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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