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General NPI Number Information
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NPI Number | 1124197132
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Entity Type | Individual
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Provider Name | MARY BYRNE KLEM MS RD LDN
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Gender | Female
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Dates
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Enumeration Date | 11/06/2006
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Last Update Date | 08/30/2025
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Provider Practice Location Address
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Address Line | 1000 MEADE ST STE 205
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City | DUNMORE
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State | PA
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Zip | 18512-3197
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Country | US
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Telephone | 570-983-3761
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Fax | 570-256-1057
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Provider Business Mailing Address
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Address Line | 231 CHAPMAN LAKE RD
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City | SCOTT TWP
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State | PA
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Zip | 18433-7718
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Country | US
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Telephone | 570-254-6495
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Fax | 570-256-1057
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 133V00000X
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Taxonomy Name | Registered Dietitian
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License Number | DN000794
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 133VN1301X
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Taxonomy Name | Oncology Nutrition Registered Dietitian
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License Number | DN000794
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License Number State | PA
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