Provider Demographics
NPI:1902584071
Name:WYZE NUTRITION LLC
Entity Type:Organization
Organization Name:WYZE NUTRITION LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:CHAYA
Authorized Official - Middle Name:
Authorized Official - Last Name:WILHELM
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:347-268-3494
Mailing Address - Street 1:25 BALFOUR PL
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11225-4508
Mailing Address - Country:US
Mailing Address - Phone:347-268-3494
Mailing Address - Fax:
Practice Address - Street 1:25 BALFOUR PL
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11225-4508
Practice Address - Country:US
Practice Address - Phone:347-268-3494
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-07-10
Last Update Date:2023-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty