Nutrisource Inc
Nutrisource Inc is a healthcare organization registered as Metabolic Nutrition Registered Dietitian in Great Neck, NY, holding Type 2 (organization) NPI 1588857858 since 2007. The authorized official on file is Nicolette Pace, President Managing Director.
✓ Active NPI ✓ Valid NPI checksum
| NPI | 1588857858 |
|---|---|
| Entity type | Organization (Type 2) |
| Legal business name | Nutrisource Inc |
| Practice address | 295 NORTHERN BLVD, SUITE 105, Great Neck, NY, 11021 |
| Phone | 5164823100 |
| Fax | 5164823131 |
| Enumeration date | 2007-08-21 |
| Last updated in NPPES | 2011-11-22 |
Authorized official
| Name | Nicolette Pace |
|---|---|
| Title | President Managing Director |
| Phone | 5164823100 |
Taxonomy & classification
| Taxonomy code | Specialty | Primary | License | State |
|---|---|---|---|---|
| 133VN1006X | Metabolic Nutrition Registered Dietitian | Primary | 005258 | NY |
Copy-ready billing details
Provider: Nutrisource Inc NPI: 1588857858 Taxonomy: 133VN1006X (Metabolic Nutrition Registered Dietitian) Address: 295 NORTHERN BLVD, SUITE 105, Great Neck, NY, 11021
Providers at this address
| NPI | Name | Type | Specialty | Location |
|---|---|---|---|---|
| 1417928821 | Nicolette Pace | Individual | Registered Dietitian | Great Neck, NY |
| 1477755387 | Xiaoling Fang | Individual | Acupuncturist | Great Neck, NY |
| 1265759245 | Almas Nazir | Individual | Psychiatry Physician | Great Neck, NY |
| 1467765685 | Frederic Rakowitz, M.D., Ph.D., PC | Organization | Internal Medicine Physician | Great Neck, NY |
Verify this record
Cross-check NPI 1588857858 against the authoritative CMS record: view Nutrisource Inc on the official NPPES registry .
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes — even if the provider moves or changes specialty. Read the full guide or validate an NPI number.
Frequently asked questions
What is the NPI number for Nutrisource Inc?
Who is the authorized official for Nutrisource Inc?
Source: CMS NPPES (public data). Snapshot 2026-07-11. Provider record last updated 2011-11-22.