Doctor Name: | AMY LORRAINE STACY |
NPI Number: | 1053539023 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MS, RD, CDN |
License Number: | 000777-1 |
Business Practice Address: | 156 West Ave Brockport, NY - 144201229 |
Business Phone Number: | 5853956095 |
Business Fax Number: | |
Mailing Address: | 7434 Maple Ave, BERGEN |
State: | NY |
Postal Code: | 144169404 |
Phone Number: | 5854941505 |
Fax Number: | |
NPI Enumeration Date: | 04/23/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 133V00000X |
License Number: | 000777-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Dietary & Nutritional Service Providers |
Taxonomy Classification: | Dietitian, Registered |
Taxonomy Specialization: | |
Taxonomy Definition: | A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor |