Provider Demographics
NPI:1659984904
Name:HOSTETLER, SKYLAR (MS, RD, CDN)
Entity Type:Individual
Prefix:
First Name:SKYLAR
Middle Name:
Last Name:HOSTETLER
Suffix:
Gender:F
Credentials:MS, RD, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 SAINT FELIX ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11217-3032
Mailing Address - Country:US
Mailing Address - Phone:914-714-1279
Mailing Address - Fax:
Practice Address - Street 1:86 SAINT FELIX ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11217-3032
Practice Address - Country:US
Practice Address - Phone:718-250-8981
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-26
Last Update Date:2020-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010266133VN1201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight Management