Provider Demographics
NPI:1033556071
Name:MARKSTEINER, KELSEY (RD)
Entity Type:Individual
Prefix:
First Name:KELSEY
Middle Name:
Last Name:MARKSTEINER
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3029 41ST ST
Mailing Address - Street 2:APT 2R
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11103-3421
Mailing Address - Country:US
Mailing Address - Phone:978-870-7640
Mailing Address - Fax:
Practice Address - Street 1:3029 41ST ST
Practice Address - Street 2:APT 2R
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11103-3421
Practice Address - Country:US
Practice Address - Phone:978-870-7640
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-05-31
Last Update Date:2013-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86013673133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered