Organization · NPI-2

Functional Nutrition Li PLLC

Dietitian, Registered · Babylon, NY

NPI number1548874563
StatusActive
Last updated in NPPESJan 31, 2025

Details

NPI
1548874563
Entity type
Organization (NPI-2)
Legal business name
Functional Nutrition Li PLLC
Organization subpart
No
Enumeration date
Sep 8, 2020
Certification date
Jan 31, 2025
Last updated
Jan 31, 2025

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
133V00000X Dietitian, Registered––Yes

Other names

  • Functional Nutrition Rx (Doing Business As)
  • Functional Nutrition Rx, INC. (Former Legal Business Name)

Practice location

41 John St
Babylon, NY 11702-2932

Phone 631-204-3375

Mailing address

41 John St
Babylon, NY 11702-2932

Phone 631-204-3375

Authorized official

Christina Lombardi
Ceo
6312043375

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