Provider Demographics
NPI:1902382674
Name:KOSKO, MARGARITA M (MS,RDN,LDN)
Entity Type:Individual
Prefix:
First Name:MARGARITA
Middle Name:M
Last Name:KOSKO
Suffix:
Gender:F
Credentials:MS,RDN,LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 REDWOOD LN
Mailing Address - Street 2:
Mailing Address - City:LEBANON
Mailing Address - State:PA
Mailing Address - Zip Code:17046-2053
Mailing Address - Country:US
Mailing Address - Phone:717-272-3242
Mailing Address - Fax:
Practice Address - Street 1:909 REDWOOD LN
Practice Address - Street 2:
Practice Address - City:LEBANON
Practice Address - State:PA
Practice Address - Zip Code:17046-2053
Practice Address - Country:US
Practice Address - Phone:717-272-3242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-07-16
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN000419133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered