Provider Demographics
NPI:1912881038
Name:EAST COAST NUTRITIONAL CONCEPTS LLC
Entity type:Organization
Organization Name:EAST COAST NUTRITIONAL CONCEPTS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN / OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:MICHELLE
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:LAMOUREUX
Authorized Official - Suffix:
Authorized Official - Credentials:RD, LDN
Authorized Official - Phone:401-595-5407
Mailing Address - Street 1:38C WATERVIEW DRIVE
Mailing Address - Street 2:
Mailing Address - City:SMITHFIELD
Mailing Address - State:RI
Mailing Address - Zip Code:02917-1790
Mailing Address - Country:US
Mailing Address - Phone:401-595-5407
Mailing Address - Fax:401-633-7575
Practice Address - Street 1:41 SANDERSON ROAD
Practice Address - Street 2:SUITE 201
Practice Address - City:SMITHFIELD
Practice Address - State:RI
Practice Address - Zip Code:02917-2602
Practice Address - Country:US
Practice Address - Phone:401-595-5407
Practice Address - Fax:401-633-7575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-08-01
Last Update Date:2025-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty