Provider Demographics
NPI:1023736899
Name:NADAL NUTRITION
Entity type:Organization
Organization Name:NADAL NUTRITION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CAREY
Authorized Official - Middle Name:
Authorized Official - Last Name:NADAL
Authorized Official - Suffix:
Authorized Official - Credentials:RD, CSR
Authorized Official - Phone:252-267-7556
Mailing Address - Street 1:5756 WALNUT WOOD LN
Mailing Address - Street 2:
Mailing Address - City:BURKE
Mailing Address - State:VA
Mailing Address - Zip Code:22015-2709
Mailing Address - Country:US
Mailing Address - Phone:252-267-7556
Mailing Address - Fax:
Practice Address - Street 1:14143 ROBERT PARIS CT
Practice Address - Street 2:
Practice Address - City:CHANTILLY
Practice Address - State:VA
Practice Address - Zip Code:20151-4201
Practice Address - Country:US
Practice Address - Phone:757-585-3441
Practice Address - Fax:888-972-7994
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-08-18
Last Update Date:2023-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, RenalGroup - Single Specialty