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General NPI Number Information
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NPI Number | 1780534503
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Entity Type | Organization
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Legal Business Name | PUTNAM PERSONALIZED NUTRITION CARE PLLC
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Dates
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Enumeration Date | 01/31/2026
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Last Update Date | 01/31/2026
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Provider Practice Location Address
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Address Line | 16 MOUNT EBO RD S STE 15A
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City | BREWSTER
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State | NY
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Zip | 10509-4037
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Country | US
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Telephone | 914-458-1951
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Fax |
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Provider Business Mailing Address
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Address Line | 16 MOUNT EBO RD S STE 15A
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City | BREWSTER
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State | NY
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Zip | 10509-4037
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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 | OWNER
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Name | ANGELA IOVINE
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Credential |
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Telephone | 914-458-1951
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QC1500X
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Taxonomy Name | Community Health Clinic/Center
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License Number |
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License Number State |
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