MEDICARE: MRS. KATHLEEN KORNACKI RD, CDN, CSP, CNSC

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	006449	NY

General Provider Information

NPI Number	:	1609038132
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. KATHLEEN KORNACKI RD, CDN, CSP, CNSC

Provider Business Mailing Address
First Line	:	3980A SHERIDAN DR
Second Line	:
City	:	AMHERST
State	:	NY
Zip	:	14226-1741
Country	:	US
Telephone Number	:	716-631-8400
Fax Number	:	716-631-8408

Provider Business Practice Location Address
First Line	:	3980A SHERIDAN DR
Second Line	:
City	:	AMHERST
State	:	NY
Zip	:	14226-1741
Country	:	US
Telephone Number	:	716-631-8400
Fax Number	:	716-631-8408

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

Provider Enumeration Date	:	06/26/2008
Last Update Date	:	04/13/2021

Similar Medicare Providers

1689008724 — JESSICA D'AMOUR PHARMD, RPH
Practice Location Address:

3980 SHERIDAN DR STE 101
AMHERST, NY
14226-1741

Practice Phone: 716-676-6655
Practice Fax:

1477998060 — SVETLANA PRIMMA ECKERT M.D.
Practice Location Address:

3980A SHERIDAN DR FL 2
AMHERST, NY
14226-1741

Practice Phone: 716-250-2000
Practice Fax:

1558546820 — CASSANDRA WILLIAMS MD
Practice Location Address:

3980A SHERIDAN DR STE 200
AMHERST, NY
14226-1741

Practice Phone: 716-309-4772
Practice Fax:

1043458367 — DR. RAKHI SHAH BARKOWSKI M.D.
Practice Location Address:

3980A SHERIDAN DR STE 200
AMHERST, NY
14226-1741

Practice Phone: 716-852-4772
Practice Fax:

1255650842 — DR. ANNE CAROLINE BANAS M.D.
Practice Location Address:

3980A SHERIDAN DR STE 200
AMHERST, NY
14226-1741

Practice Phone: 716-852-4772
Practice Fax:

1518251198 — DR. ANDREW LAWRENCE SMITH M.D.
Practice Location Address:

3980A SHERIDAN DR
AMHERST, NY
14226-1741

Practice Phone: 716-250-2000
Practice Fax: 716-250-2045

Directions to “ MRS. KATHLEEN KORNACKI RD, CDN, CSP, CNSC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.