Provider Demographics
NPI:1679008825
Name:KOTFILA, JOSHUA MARK (RDN)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:MARK
Last Name:KOTFILA
Suffix:
Gender:M
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 SILVER HILL LN APT 7
Mailing Address - Street 2:
Mailing Address - City:NATICK
Mailing Address - State:MA
Mailing Address - Zip Code:01760-3738
Mailing Address - Country:US
Mailing Address - Phone:650-867-1637
Mailing Address - Fax:
Practice Address - Street 1:42 SILVER HILL LN APT 7
Practice Address - Street 2:
Practice Address - City:NATICK
Practice Address - State:MA
Practice Address - Zip Code:01760-3738
Practice Address - Country:US
Practice Address - Phone:650-867-1637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-04-25
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered