Provider Demographics
NPI:1871305672
Name:GATEWAY NUTRITION SOLUTIONS, LLC
Entity type:Organization
Organization Name:GATEWAY NUTRITION SOLUTIONS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AUSTIN
Authorized Official - Middle Name:
Authorized Official - Last Name:KAHARI
Authorized Official - Suffix:
Authorized Official - Credentials:MS, RDN, CSR, LDN
Authorized Official - Phone:570-561-7718
Mailing Address - Street 1:273 STONE LN
Mailing Address - Street 2:
Mailing Address - City:FACTORYVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18419-7957
Mailing Address - Country:US
Mailing Address - Phone:570-561-7718
Mailing Address - Fax:
Practice Address - Street 1:273 STONE LN
Practice Address - Street 2:
Practice Address - City:FACTORYVILLE
Practice Address - State:PA
Practice Address - Zip Code:18419-7957
Practice Address - Country:US
Practice Address - Phone:570-561-7718
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-21
Last Update Date:2025-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133VN1005XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, RenalGroup - Multi-Specialty
No133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, MetabolicGroup - Multi-Specialty
No133VN1201XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Obesity and Weight ManagementGroup - Multi-Specialty