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Contact Information

CODY W BOLSTER
262 MANHATTAN BLVD
ISLIP TERRACE, NY11752
 Phone: 631-707-5786
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dietitian, Registered

133V00000X 71 Registered Dietitian or Nutrition Professional
Indicates primary specialty

NPI Profile & details for CODY W BOLSTER · (Male)

NPI # 1225987126
Status Active
Credentials
Entity Individual
Enumeration date 01/23/2026
Last updated 01/23/2026 - About 4 months ago
Sole proprietor 1 No
Identifiers
  • NY License # 013170
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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