Provider Demographics
NPI:1083596837
Name:SKIDELL, STEFANI
Entity type:Individual
Prefix:
First Name:STEFANI
Middle Name:
Last Name:SKIDELL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 BUCKINGHAM ST UNIT 106
Mailing Address - Street 2:
Mailing Address - City:MORGANVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:07751-4288
Mailing Address - Country:US
Mailing Address - Phone:516-650-2235
Mailing Address - Fax:
Practice Address - Street 1:10 BUCKINGHAM ST UNIT 106
Practice Address - Street 2:
Practice Address - City:MORGANVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07751-4288
Practice Address - Country:US
Practice Address - Phone:516-650-2235
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered