Provider Demographics
NPI:1144943309
Name:NUTRITION SCHOOL LLC
Entity type:Organization
Organization Name:NUTRITION SCHOOL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:WADOLOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LDN, CHC, CDCES
Authorized Official - Phone:631-897-3294
Mailing Address - Street 1:2723 ALMOND ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19134-4707
Mailing Address - Country:US
Mailing Address - Phone:631-897-3294
Mailing Address - Fax:
Practice Address - Street 1:2723 ALMOND ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19134-4707
Practice Address - Country:US
Practice Address - Phone:631-897-3294
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-22
Last Update Date:2022-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty