MEDICARE: KYRA ANN GALONEK

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	133V00000X	Registered Dietitian	LDN8389	MA

General Provider Information

NPI Number	:	1457204992
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KYRA ANN GALONEK

Provider Business Mailing Address
First Line	:	135 SHORE RD
Second Line	:
City	:	STURBRIDGE
State	:	MA
Zip	:	01566-1363
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	145 FRONT ST UNIT 1213
Second Line	:
City	:	WORCESTER
State	:	MA
Zip	:	01608-1450
Country	:	US
Telephone Number	:	774-230-1953
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/16/2026
Last Update Date	:	02/16/2026

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