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NPI Code Detail

MEDICARE: PCOS NUTRITION LLC

MEDICARE: PCOS 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
1133V00000XRegistered Dietitian

General Provider Information

NPI Number : 1730038753
Entity Type Code : Organization
Provider Name (Legal Business Name) : PCOS NUTRITION LLC
Provider Business Mailing Address
First Line : 100 ENTERPRISE DR STE 301
Second Line :
City : ROCKAWAY
State : NJ
Zip : 07866-2129
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 100 ENTERPRISE DR STE 301
Second Line :
City : ROCKAWAY
State : NJ
Zip : 07866-2129
Country : US
Telephone Number : 973-791-7450
Fax Number :
Authorized Official
Title or Position : REGISTERED DIETITIAN
Name : LAUREN KULIK
Credential : RDN
Telephone Number : 804-814-1372
Provider Enumeration Date : 01/23/2026
Last Update Date : 01/23/2026

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Directions to “PCOS NUTRITION LLC ” Practice Location

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