Provider Demographics
NPI:1417625948
Name:HOCHSTADTER, SHIRA (RDN, LDN)
Entity Type:Individual
Prefix:MS
First Name:SHIRA
Middle Name:
Last Name:HOCHSTADTER
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6417 ELRAY DR APT E
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-2928
Mailing Address - Country:US
Mailing Address - Phone:443-760-8881
Mailing Address - Fax:
Practice Address - Street 1:6417 ELRAY DR APT E
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-2928
Practice Address - Country:US
Practice Address - Phone:443-760-8881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-31
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDDX4798133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered