Provider Demographics
NPI:1326507518
Name:BAIR, KERRY (RD, LDN, MPH)
Entity Type:Individual
Prefix:
First Name:KERRY
Middle Name:
Last Name:BAIR
Suffix:
Gender:F
Credentials:RD, LDN, MPH
Other - Prefix:
Other - First Name:KERRY
Other - Middle Name:
Other - Last Name:SILVERMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:106 WINDING WAY
Mailing Address - Street 2:
Mailing Address - City:TELFORD
Mailing Address - State:PA
Mailing Address - Zip Code:18969-2163
Mailing Address - Country:US
Mailing Address - Phone:973-876-5462
Mailing Address - Fax:
Practice Address - Street 1:106 WINDING WAY
Practice Address - Street 2:
Practice Address - City:TELFORD
Practice Address - State:PA
Practice Address - Zip Code:18969-2163
Practice Address - Country:US
Practice Address - Phone:973-876-5462
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-18
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86075320133V00000X
PADN006533133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered