Provider Demographics
NPI:1376976373
Name:STASHKO, MARY CHRISTINA (ND PHD)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:CHRISTINA
Last Name:STASHKO
Suffix:
Gender:F
Credentials:ND PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2913 MAIN RD E
Mailing Address - Street 2:
Mailing Address - City:EMMAUS
Mailing Address - State:PA
Mailing Address - Zip Code:18049-4742
Mailing Address - Country:US
Mailing Address - Phone:610-965-8132
Mailing Address - Fax:610-965-8132
Practice Address - Street 1:2913 MAIN RD E
Practice Address - Street 2:
Practice Address - City:EMMAUS
Practice Address - State:PA
Practice Address - Zip Code:18049-4742
Practice Address - Country:US
Practice Address - Phone:610-965-8132
Practice Address - Fax:610-965-8132
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-13
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133N00000XDietary & Nutritional Service ProvidersNutritionist