MEDICARE: ANN SILVER NUTRITION, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian

General Provider Information

NPI Number	:	1255927604
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ANN SILVER NUTRITION, LLC

Provider Business Mailing Address
First Line	:	PO BOX 399
Second Line	:
City	:	SAG HARBOR
State	:	NY
Zip	:	11963-0008
Country	:	US
Telephone Number	:	631-324-1953
Fax Number	:

Provider Business Practice Location Address
First Line	:	200 PANTIGO PL STE I
Second Line	:
City	:	EAST HAMPTON
State	:	NY
Zip	:	11937-5922
Country	:	US
Telephone Number	:	631-324-1953
Fax Number	:

Authorized Official
Title or Position	:	NUTRITIONIST
Name	:	ANN SILVER
Credential	:	MS, RDN, CDCES, CDN
Telephone Number	:	631-324-1953

Provider Enumeration Date	:	12/18/2020
Last Update Date	:	12/18/2020

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