Provider Demographics
NPI:1407027451
Name:SCHIDLER, CORY (BS, HFI)
Entity Type:Individual
Prefix:MR
First Name:CORY
Middle Name:
Last Name:SCHIDLER
Suffix:
Gender:M
Credentials:BS, HFI
Other - Prefix:MRS
Other - First Name:DANIELLE
Other - Middle Name:
Other - Last Name:LAFATA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MA, RD, CPT
Mailing Address - Street 1:7500 E PINNACLE PEAK RD
Mailing Address - Street 2:SUITE A-109
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85255-3406
Mailing Address - Country:US
Mailing Address - Phone:480-585-4010
Mailing Address - Fax:480-342-9769
Practice Address - Street 1:7500 E PINNACLE PEAK RD
Practice Address - Street 2:SUITE A-109
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85255-3406
Practice Address - Country:US
Practice Address - Phone:480-585-4010
Practice Address - Fax:480-342-9769
Is Sole Proprietor?:No
Enumeration Date:2008-03-18
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI961282133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered