Provider Demographics
NPI:1891547840
Name:KUTLER, PAIGE SKYLAR (MS, RDN)
Entity Type:Individual
Prefix:
First Name:PAIGE
Middle Name:SKYLAR
Last Name:KUTLER
Suffix:
Gender:F
Credentials:MS, RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:31 LORETTA CIR
Mailing Address - Street 2:
Mailing Address - City:RICHBORO
Mailing Address - State:PA
Mailing Address - Zip Code:18954-1438
Mailing Address - Country:US
Mailing Address - Phone:215-809-9891
Mailing Address - Fax:
Practice Address - Street 1:6750 IROQUOIS TRL STE 12
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18104-8644
Practice Address - Country:US
Practice Address - Phone:610-395-9595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-03
Last Update Date:2024-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86393269133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered