Provider Demographics
NPI:1184207722
Name:MASCHEK, LYNDA (RDN)
Entity Type:Individual
Prefix:
First Name:LYNDA
Middle Name:
Last Name:MASCHEK
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:126 DARCY AVE
Mailing Address - Street 2:
Mailing Address - City:GOOSE CREEK
Mailing Address - State:SC
Mailing Address - Zip Code:29445-6664
Mailing Address - Country:US
Mailing Address - Phone:330-398-2488
Mailing Address - Fax:
Practice Address - Street 1:126 DARCY AVE
Practice Address - Street 2:
Practice Address - City:GOOSE CREEK
Practice Address - State:SC
Practice Address - Zip Code:29445-6664
Practice Address - Country:US
Practice Address - Phone:330-398-2488
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-02
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC605133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered