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NPI Code Detail

MEDICARE: KATRIN KALO LEE RD, CDN

MEDICARE:   KATRIN KALO LEE  RD, CDN
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
1133V00000XRegistered Dietitian1034217NY

General Provider Information

NPI Number : 1851643563
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATRIN KALO LEE RD, CDN
Provider Business Mailing Address
First Line : 22 N 6TH ST
Second Line : 20I
City : BROOKLYN
State : NY
Zip : 11249-3075
Country : US
Telephone Number : 646-262-5445
Fax Number :
Provider Business Practice Location Address
First Line : 22 N 6TH ST
Second Line : 20I
City : BROOKLYN
State : NY
Zip : 11249-3075
Country : US
Telephone Number : 646-262-5445
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/04/2012
Last Update Date : 10/04/2012

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Directions to “ KATRIN KALO LEE RD, CDN” Practice Location

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