Provider Demographics
NPI:1144734450
Name:HOSKINS, ELIZABETH (RD)
Entity type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:
Last Name:HOSKINS
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:793 CLARK STREET RD
Mailing Address - Street 2:
Mailing Address - City:CAYUGA
Mailing Address - State:NY
Mailing Address - Zip Code:13034-2113
Mailing Address - Country:US
Mailing Address - Phone:315-246-3834
Mailing Address - Fax:
Practice Address - Street 1:793 CLARK STREET RD
Practice Address - Street 2:
Practice Address - City:CAYUGA
Practice Address - State:NY
Practice Address - Zip Code:13034-2113
Practice Address - Country:US
Practice Address - Phone:315-246-3834
Practice Address - Fax:315-246-3834
Is Sole Proprietor?:Yes
Enumeration Date:2017-11-22
Last Update Date:2017-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY009208-1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered