Healthcare Provider Details

I. General information

NPI: 1356926349
Provider Name (Legal Business Name): KRISHNA DHOLAKIA MS, RD, CDCES, CDN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/11/2021
Last Update Date: 09/26/2023
Certification Date: 09/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

418 BROADWAY
ALBANY NY
12207-2922
US

IV. Provider business mailing address

418 BROADWAY
ALBANY NY
12207-2922
US

V. Phone/Fax

Practice location:
  • Phone: 347-497-0019
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133V00000X
TaxonomyRegistered Dietitian
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: