Provider Demographics
NPI:1447762141
Name:LEVY, MARCY C (RDN, LDN)
Entity Type:Individual
Prefix:MRS
First Name:MARCY
Middle Name:C
Last Name:LEVY
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 TEABERRY LN
Mailing Address - Street 2:
Mailing Address - City:NEWTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18940-9214
Mailing Address - Country:US
Mailing Address - Phone:267-334-6655
Mailing Address - Fax:
Practice Address - Street 1:23 TEABERRY LN
Practice Address - Street 2:
Practice Address - City:NEWTOWN
Practice Address - State:PA
Practice Address - Zip Code:18940-9214
Practice Address - Country:US
Practice Address - Phone:267-334-6655
Practice Address - Fax:215-860-5754
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-02
Last Update Date:2017-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN001893133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered