Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
JEAN KOSTAK, MS, RD
ActiveNutrition, Education · FARMINGTON, CT
Registration Details
- NPI Number
- 1427105550
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Jan 4, 2007 (19.334346222711 yrs)
- Last Updated
- Sep 26, 2022
- License
-
000312 (CT)
Practice Information
- Address
-
263 FARMINGTON AVEFARMINGTON, CT, 060306220Browse CT providers · Browse ZIP 06030
- Phone
- 8606794477
- Fax
- 8606794474
- Primary Specialty
-
Nutrition, Education
133NN1002X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.