=====================================================
General NPI Number Information
=====================================================
NPI Number | 1881361590
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HAPPY HEALTH NUTRITION LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/30/2021
-----------------------------------------------------
Last Update Date | 10/27/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 9 PINE RIDGE DR
-----------------------------------------------------
City | SUMMIT
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07901-2437
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-705-3725
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9 PINE RIDGE DR
-----------------------------------------------------
City | SUMMIT
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07901-2437
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-705-3725
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | REGISTERED DIETITIAN NUTRITIONIST
-----------------------------------------------------
Name | LAUREN BUDD LEVY
-----------------------------------------------------
Credential | MS, RDN, LD, CSR
-----------------------------------------------------
Telephone | 609-705-3725
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 133VN1005X
-----------------------------------------------------
Taxonomy Name | Renal Nutrition Registered Dietitian
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------