Provider Demographics
NPI:1568552099
Name:UNITED HEALTH & WELLNESS, LLC
Entity Type:Organization
Organization Name:UNITED HEALTH & WELLNESS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR VICE PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:JODY
Authorized Official - Middle Name:
Authorized Official - Last Name:LAMARCA
Authorized Official - Suffix:
Authorized Official - Credentials:RD, CDN
Authorized Official - Phone:716-630-6648
Mailing Address - Street 1:2813 WEHRLE DR
Mailing Address - Street 2:SUITE 11
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-7384
Mailing Address - Country:US
Mailing Address - Phone:716-630-6648
Mailing Address - Fax:716-630-6647
Practice Address - Street 1:2813 WEHRLE DR
Practice Address - Street 2:SUITE 11
Practice Address - City:WILLIAMSVILLE
Practice Address - State:NY
Practice Address - Zip Code:14221-7384
Practice Address - Country:US
Practice Address - Phone:716-630-6648
Practice Address - Fax:716-630-6647
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY833179133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty