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NPI Code Detail

MEDICARE: MS. LYNN MARIE DEMARCO MS, RD, CDN, CDE

MEDICARE: MS. LYNN MARIE DEMARCO MS, RD, CDN, CDE
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1133V00000XRegistered Dietitian006297-1NY

General Provider Information

NPI Number : 1023325339
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. LYNN MARIE DEMARCO MS, RD, CDN, CDE
Provider Business Mailing Address
First Line : 3724 JEFFERSON ST STE 104
Second Line :
City : AUSTIN
State : TX
Zip : 78731-6204
Country : US
Telephone Number : 347-804-2013
Fax Number :
Provider Business Practice Location Address
First Line : 3724 JEFFERSON ST STE 104
Second Line : SUITE 104
City : AUSTIN
State : TX
Zip : 78731-6204
Country : US
Telephone Number : 347-804-2013
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2010
Last Update Date : 12/08/2025

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