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General NPI Number Information
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NPI Number | 1649140351
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Entity Type | Organization
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Legal Business Name | ALIV WELLNESS
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Dates
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Enumeration Date | 11/07/2025
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Last Update Date | 11/07/2025
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Provider Practice Location Address
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Address Line | 1087 ROUTE 58 # 1077
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City | RIVERHEAD
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State | NY
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Zip | 11901-2141
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Country | US
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Telephone | 631-594-8021
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Fax | 631-594-7322
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Provider Business Mailing Address
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Address Line | 1087 ROUTE 58 # 1077
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City | RIVERHEAD
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State | NY
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Zip | 11901-2141
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Country | US
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Telephone | 631-594-8021
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Fax | 631-594-7322
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Authorized Official
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Title or Position | NUTRITIONIST, OWNER
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Name | ANTOINETTE LIVIOLA
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Credential | MS, CNS, LDN
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Telephone | 201-344-8653
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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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