Provider Demographics
NPI:1043758642
Name:TOCZEK, LAURA (MBA, RD, CDN)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:
Last Name:TOCZEK
Suffix:
Gender:F
Credentials:MBA, RD, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 MIDDLEBURY LN
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:NY
Mailing Address - Zip Code:14086-1547
Mailing Address - Country:US
Mailing Address - Phone:716-390-9090
Mailing Address - Fax:716-901-7345
Practice Address - Street 1:49 MIDDLEBURY LN
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:NY
Practice Address - Zip Code:14086-1547
Practice Address - Country:US
Practice Address - Phone:716-390-9090
Practice Address - Fax:716-901-7345
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-03
Last Update Date:2017-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY920736133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered