Provider Demographics
NPI:1619855384
Name:ANTHONY, CAITLIN ROSE (RDN)
Entity type:Individual
Prefix:
First Name:CAITLIN
Middle Name:ROSE
Last Name:ANTHONY
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:ROSE
Other - Last Name:LESKO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RDN
Mailing Address - Street 1:3369 FAIRLAND DR
Mailing Address - Street 2:
Mailing Address - City:SCHNECKSVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18078-2880
Mailing Address - Country:US
Mailing Address - Phone:570-436-3035
Mailing Address - Fax:
Practice Address - Street 1:3369 FAIRLAND DR
Practice Address - Street 2:
Practice Address - City:SCHNECKSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18078-2880
Practice Address - Country:US
Practice Address - Phone:570-436-3035
Practice Address - Fax:570-436-3035
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-21
Last Update Date:2025-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA086047664133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered