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General NPI Number Information
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NPI Number | 1487343844
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Entity Type | Organization
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Legal Business Name | STEP NUTRITION LLC
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Dates
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Enumeration Date | 05/02/2023
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Last Update Date | 05/09/2024
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Provider Practice Location Address
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Address Line | 7393 TAFT PARK DR
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City | EAST SYRACUSE
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State | NY
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Zip | 13057-9639
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Country | US
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Telephone | 315-345-1363
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 15256
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City | SYRACUSE
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State | NY
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Zip | 13215-0256
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Country | US
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Telephone | 315-345-1363
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | GREGORY M BELZAK
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Credential | RD
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Telephone | 315-345-1363
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number |
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License Number State |
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