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General NPI Number Information
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NPI Number | 1851099675
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Entity Type | Organization
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Legal Business Name | NUTRISPACE LLC
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Dates
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Enumeration Date | 02/21/2023
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Last Update Date | 03/27/2023
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Provider Practice Location Address
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Address Line | 150 BETHLEHEM PIKE
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City | COLMAR
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State | PA
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Zip | 18915-9790
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Country | US
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Telephone | 215-822-0292
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Fax |
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Provider Business Mailing Address
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Address Line | 1460 BRONTE CT
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City | LANSDALE
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State | PA
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Zip | 19446-5365
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Country | US
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Telephone | 347-735-1426
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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 | ARPANA BIDNUR
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Credential | RD
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Telephone | 347-735-1426
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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