Provider Demographics
NPI:1225857675
Name:BODNAR, ERIKA LINDSAY (MS, RD, LDN)
Entity type:Individual
Prefix:
First Name:ERIKA
Middle Name:LINDSAY
Last Name:BODNAR
Suffix:
Gender:F
Credentials:MS, RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 WOODVIEW WAY APT 1221
Mailing Address - Street 2:
Mailing Address - City:ANDOVER
Mailing Address - State:MA
Mailing Address - Zip Code:01810-4578
Mailing Address - Country:US
Mailing Address - Phone:203-942-3336
Mailing Address - Fax:
Practice Address - Street 1:100 WOODVIEW WAY APT 1221
Practice Address - Street 2:
Practice Address - City:ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01810-4578
Practice Address - Country:US
Practice Address - Phone:203-942-3336
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-03
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1929133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered