Healthcare Provider Details

I. General information

NPI: 1790392694
Provider Name (Legal Business Name): EMILY KILAR MS, CNS, LDN, CLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/25/2020
Last Update Date: 09/25/2020
Certification Date: 09/25/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 RIVERFRONT DR
PITTSBURGH PA
15238-3179
US

IV. Provider business mailing address

1305 RIVERFRONT DR
PITTSBURGH PA
15238-3179
US

V. Phone/Fax

Practice location:
  • Phone: 412-716-5635
  • Fax:
Mailing address:
  • Phone: 412-716-5635
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License NumberDN007208
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: