Provider Demographics
NPI:1508195785
Name:MARCHANT, JOAN ELIZABETH (RD, CDN)
Entity Type:Individual
Prefix:MS
First Name:JOAN
Middle Name:ELIZABETH
Last Name:MARCHANT
Suffix:
Gender:F
Credentials:RD, CDN
Other - Prefix:MS
Other - First Name:JOAN
Other - Middle Name:ELIZABETH
Other - Last Name:LUFRANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:25 WAVERLY PL
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-3503
Mailing Address - Country:US
Mailing Address - Phone:516-551-6980
Mailing Address - Fax:
Practice Address - Street 1:25 WAVERLY PL
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:NY
Practice Address - Zip Code:11735-3503
Practice Address - Country:US
Practice Address - Phone:516-551-6980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-12-16
Last Update Date:2015-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006641-1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered