Provider Demographics
NPI:1316377625
Name:ZIOLKOWSKI, KATHRYN ANN (RD, CDN)
Entity Type:Individual
Prefix:MRS
First Name:KATHRYN
Middle Name:ANN
Last Name:ZIOLKOWSKI
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 1:1200 E AND WEST RD
Mailing Address - Street 2:
Mailing Address - City:WEST SENECA
Mailing Address - State:NY
Mailing Address - Zip Code:14224-3604
Mailing Address - Country:US
Mailing Address - Phone:716-674-9701
Mailing Address - Fax:716-674-0648
Practice Address - Street 1:462 GRIDER ST
Practice Address - Street 2:IMMUNODEFICIENCY SERVICES- TUNNEL
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14215-3021
Practice Address - Country:US
Practice Address - Phone:716-898-5807
Practice Address - Fax:716-898-3187
Is Sole Proprietor?:No
Enumeration Date:2013-11-22
Last Update Date:2019-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007470-1133V00000X
NY7808616133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered