Custom Dietetics, PC
NPI 1063596880ActiveOrganization· Dietitian, Registered· Williamsville, NY
Dietitian, Registered in Williamsville, New York, registered in NPPES in October 2006. The authorized official on file is Allyson Erica Odachowski, R.D., CDN, President/Registered Dietitian. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1063596880 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Oct 25, 2006 |
| Last updated in NPPES | Mar 31, 2026 |
| Certified by provider | Mar 31, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Dietitian, Registered Primary | 133V00000X | — | — |
| Nutritionist | 133N00000X | — | — |
| Dietitian, Registered | 133V00000X | 005917-1 | NY |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (NY) |
|---|
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