Healthcare Provider Details

I. General information

NPI: 1790162691
Provider Name (Legal Business Name): GATEWAY NUTRITION SOLUTIONS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/29/2015
Last Update Date: 01/21/2025
Certification Date: 01/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

273 STONE LN
FACTORYVILLE PA
18419-7957
US

IV. Provider business mailing address

273 STONE LN
FACTORYVILLE PA
18419-7957
US

V. Phone/Fax

Practice location:
  • Phone: 570-561-7718
  • Fax:
Mailing address:
  • Phone: 570-561-7718
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code133VN1006X
TaxonomyMetabolic Nutrition Registered Dietitian
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code133VN1201X
TaxonomyObesity and Weight Management Nutrition Registered Dietitian
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code133VN1005X
TaxonomyRenal Nutrition Registered Dietitian
License Number
License Number State

VIII. Authorized Official

Name: MS. AUSTIN KAHARI
Title or Position: FOUNDER
Credential: MS,RDN, CSR, LDN, CD
Phone: 570-561-7718