Provider Demographics
NPI:1528750353
Name:KASOFF, TAYLOR (RD, LDN)
Entity type:Individual
Prefix:
First Name:TAYLOR
Middle Name:
Last Name:KASOFF
Suffix:
Gender:F
Credentials:RD, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:234 S CHAPEL ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21231-2603
Mailing Address - Country:US
Mailing Address - Phone:443-604-6947
Mailing Address - Fax:
Practice Address - Street 1:234 S CHAPEL ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21231-2603
Practice Address - Country:US
Practice Address - Phone:443-604-6947
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-22
Last Update Date:2024-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133V00000X
MDDX5390133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered