Provider Demographics
NPI:1629285440
Name:MCALLISTER, KATHLEEN S (RD, CDN)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:S
Last Name:MCALLISTER
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 1:187 KENWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:DELMAR
Mailing Address - State:NY
Mailing Address - Zip Code:12054-2233
Mailing Address - Country:US
Mailing Address - Phone:518-475-1863
Mailing Address - Fax:
Practice Address - Street 1:187 KENWOOD AVE
Practice Address - Street 2:
Practice Address - City:DELMAR
Practice Address - State:NY
Practice Address - Zip Code:12054-2233
Practice Address - Country:US
Practice Address - Phone:518-475-1863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered