National Provider Identifier
Amy Lorraine Stacy, MS, RD, CDN
Amy Lorraine Stacy, MS, RD, CDN is listed in the NPPES registry with a primary specialty of Registered Dietitian in Brockport, NY and a listed phone number of (585) 395-6095.
Profile Overview
- NPI
- 1053539023
- Provider Type
- Individual
- Primary Specialty
- Registered Dietitian
- Enumeration Date
- April 23, 2007
- Last Updated
- July 08, 2007
Practice Location
- 156 West Ave
- Brockport, NY 14420-1229
Phone: (585) 395-6095
Mailing Address
- 7434 Maple Ave
- Bergen, NY 14416-9404
Specialties
- Registered Dietitian (133V00000X)
Full Record
- NPI
- 1053539023
- Entity Type
- Individual
- Last Name
- Stacy
- First Name
- Amy
- Middle Name
- Lorraine
- Credential
- MS, RD, CDN
- Mailing Street Address
- 7434 Maple Ave
- Mailing City
- Bergen
- Mailing State
- NY
- Mailing ZIP Code
- 14416-9404
- Mailing Country
- US
- Mailing Phone
- (585) 494-1505
- Practice Street Address
- 156 West Ave
- Practice City
- Brockport
- Practice State
- NY
- Practice ZIP Code
- 14420-1229
- Practice Country
- US
- Practice Phone
- (585) 395-6095
- Enumeration Date
- April 23, 2007
- Last Updated
- July 08, 2007
- Sex
- Female
- Sole Proprietor
- No
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Registered Dietitian (133V00000X)