Provider Demographics
NPI:1164119301
Name:KANE, KATE MARIE (RD, CDN)
Entity Type:Individual
Prefix:MS
First Name:KATE
Middle Name:MARIE
Last Name:KANE
Suffix:
Gender:F
Credentials:RD, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:282 DEERHURST PARK BLVD
Mailing Address - Street 2:
Mailing Address - City:TOWN OF TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14223-1911
Mailing Address - Country:US
Mailing Address - Phone:716-903-9093
Mailing Address - Fax:
Practice Address - Street 1:3495 BAILEY AVE
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215-1129
Practice Address - Country:US
Practice Address - Phone:716-495-2501
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-19
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered