Provider Demographics
NPI:1831462423
Name:LAMARCA, JODY M (RD, CDN, CDE)
Entity Type:Individual
Prefix:
First Name:JODY
Middle Name:M
Last Name:LAMARCA
Suffix:
Gender:F
Credentials:RD, CDN, CDE
Other - Prefix:
Other - First Name:JODY
Other - Middle Name:M
Other - Last Name:LAMARCA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD, CDN, CDE
Mailing Address - Street 1:987 R C HOAG DR
Mailing Address - Street 2:
Mailing Address - City:SALAMANCA
Mailing Address - State:NY
Mailing Address - Zip Code:14779-1365
Mailing Address - Country:US
Mailing Address - Phone:716-945-5894
Mailing Address - Fax:
Practice Address - Street 1:987 R C HOAG DR
Practice Address - Street 2:
Practice Address - City:SALAMANCA
Practice Address - State:NY
Practice Address - Zip Code:14779-1365
Practice Address - Country:US
Practice Address - Phone:716-945-5894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-02-14
Last Update Date:2015-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY833179133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered