Provider Demographics
NPI:1043990831
Name:MOSTEK, SYDNEE R (RDN)
Entity type:Individual
Prefix:
First Name:SYDNEE
Middle Name:R
Last Name:MOSTEK
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:276 CHARTER CT SE
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-2770
Mailing Address - Country:US
Mailing Address - Phone:660-528-0415
Mailing Address - Fax:
Practice Address - Street 1:350 GEORGE W LILES PKWY NW STE 160
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28027-2411
Practice Address - Country:US
Practice Address - Phone:660-528-0415
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-07-18
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered