Provider Demographics
NPI:1134288681
Name:KREINHEDER, ERIN K (RD, CDN)
Entity Type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:K
Last Name:KREINHEDER
Suffix:
Gender:F
Credentials:RD, CDN
Other - Prefix:MISS
Other - First Name:ERIN
Other - Middle Name:K
Other - Last Name:BRUDZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RD
Mailing Address - Street 1:78 GRAND BLVD
Mailing Address - Street 2:
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225-3053
Mailing Address - Country:US
Mailing Address - Phone:716-894-4588
Mailing Address - Fax:716-891-2788
Practice Address - Street 1:2605 HARLEM RD
Practice Address - Street 2:
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-4018
Practice Address - Country:US
Practice Address - Phone:716-891-2400
Practice Address - Fax:716-891-2788
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005809-1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered