Provider Demographics
NPI:1518583632
Name:CHRISTOFF, KENDEL R (RD)
Entity Type:Individual
Prefix:MRS
First Name:KENDEL
Middle Name:R
Last Name:CHRISTOFF
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 1:32 JEFFERSON AVE STE 210
Mailing Address - Street 2:
Mailing Address - City:SHARON
Mailing Address - State:PA
Mailing Address - Zip Code:16146-3354
Mailing Address - Country:US
Mailing Address - Phone:724-981-4561
Mailing Address - Fax:
Practice Address - Street 1:32 JEFFERSON AVE STE 210
Practice Address - Street 2:
Practice Address - City:SHARON
Practice Address - State:PA
Practice Address - Zip Code:16146-3354
Practice Address - Country:US
Practice Address - Phone:724-983-7324
Practice Address - Fax:724-983-5515
Is Sole Proprietor?:No
Enumeration Date:2020-06-24
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN006751133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered