Provider Demographics
NPI:1992424964
Name:THE NUTRITION QUEENS, LLC
Entity type:Organization
Organization Name:THE NUTRITION QUEENS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:JUSTINE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROSADO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-614-4691
Mailing Address - Street 1:9411 69TH AVE APT 206
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-5801
Mailing Address - Country:US
Mailing Address - Phone:718-614-4691
Mailing Address - Fax:
Practice Address - Street 1:9411 69TH AVE APT 206
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-5801
Practice Address - Country:US
Practice Address - Phone:718-614-4691
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-24
Last Update Date:2022-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Multi-Specialty