Provider Demographics
NPI:1689253825
Name:KOLANKIEWICZ, ALLISON (RDN)
Entity Type:Individual
Prefix:
First Name:ALLISON
Middle Name:
Last Name:KOLANKIEWICZ
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:512 GEORGETOWN RD
Mailing Address - Street 2:
Mailing Address - City:WALLINGFORD
Mailing Address - State:PA
Mailing Address - Zip Code:19086-6960
Mailing Address - Country:US
Mailing Address - Phone:484-620-6335
Mailing Address - Fax:
Practice Address - Street 1:512 GEORGETOWN RD
Practice Address - Street 2:
Practice Address - City:WALLINGFORD
Practice Address - State:PA
Practice Address - Zip Code:19086-6960
Practice Address - Country:US
Practice Address - Phone:484-620-6335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-05
Last Update Date:2021-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN007127133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered