Provider Demographics
NPI:1396925582
Name:BESCHLER, JOHN STEVEN (RDLDN)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:STEVEN
Last Name:BESCHLER
Suffix:
Gender:M
Credentials:RDLDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1503 17TH AVE
Mailing Address - Street 2:
Mailing Address - City:ALTOONA
Mailing Address - State:PA
Mailing Address - Zip Code:16601-3151
Mailing Address - Country:US
Mailing Address - Phone:814-944-9980
Mailing Address - Fax:
Practice Address - Street 1:1503 17TH AVE
Practice Address - Street 2:
Practice Address - City:ALTOONA
Practice Address - State:PA
Practice Address - Zip Code:16601-3151
Practice Address - Country:US
Practice Address - Phone:814-944-9980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-06
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN000154133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PABE1793577OtherHIGHMARK BC/BS
PA0000057343Medicare NSC