Provider Demographics
NPI:1306719422
Name:STOKLOSA, KATLYN (RDN, CDN)
Entity type:Individual
Prefix:
First Name:KATLYN
Middle Name:
Last Name:STOKLOSA
Suffix:
Gender:F
Credentials:RDN, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1407 98TH ST
Mailing Address - Street 2:
Mailing Address - City:NIAGARA FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14304-2703
Mailing Address - Country:US
Mailing Address - Phone:716-989-9501
Mailing Address - Fax:
Practice Address - Street 1:1407 98TH ST
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14304-2703
Practice Address - Country:US
Practice Address - Phone:716-989-9501
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-25
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012936133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered