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General NPI Number Information
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NPI Number | 1710881834
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Entity Type | Organization
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Legal Business Name | PWRNUTRITION LLC
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Dates
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Enumeration Date | 10/03/2026
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Last Update Date | 10/03/2026
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Provider Practice Location Address
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Address Line | 118 OUTLET RD
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City | CAROGA LAKE
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State | NY
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Zip | 12032-7726
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Country | US
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Telephone | 845-453-6115
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 208
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City | CAROGA LAKE
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State | NY
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Zip | 12032-0208
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Country | US
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Telephone | 845-453-6115
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Fax |
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Authorized Official
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Title or Position | REGISTERED DIETITIAN
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Name | RACHEL MCGARRY-CERNAK
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Credential | MS, RD, CSSD
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Telephone | 845-453-6115
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number |
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License Number State | NULL
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Taxonomy #2
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Taxonomy Code | 133VN1501X
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Taxonomy Name | Sports Dietetics Nutrition Registered Dietitian
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License Number |
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License Number State | NULL
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