Provider Demographics
NPI:1598570756
Name:LMG NUTRITION PLLC
Entity type:Organization
Organization Name:LMG NUTRITION PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:GANGEMI
Authorized Official - Suffix:
Authorized Official - Credentials:RD
Authorized Official - Phone:646-460-7129
Mailing Address - Street 1:1365 N RAILROAD AVE STE 118
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-2348
Mailing Address - Country:US
Mailing Address - Phone:646-460-7129
Mailing Address - Fax:
Practice Address - Street 1:100 FOSTER RD APT B
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10309-3011
Practice Address - Country:US
Practice Address - Phone:646-460-7129
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-12
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty