Healthcare Provider Details

I. General information

NPI: 1023313111
Provider Name (Legal Business Name): MARGARET ANN HODSON RD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/20/2011
Last Update Date: 01/20/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 S ELMWOOD AVE
BUFFALO NY
14201-2398
US

IV. Provider business mailing address

110 LARNED LN
ORCHARD PARK NY
14127-2306
US

V. Phone/Fax

Practice location:
  • Phone: 716-847-2441
  • Fax:
Mailing address:
  • Phone: 716-662-3083
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133N00000X
TaxonomyNutritionist
License Number0010251
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number0010251
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: