Provider Demographics
NPI:1821025974
Name:KOLANKOWSKI, DENISE M (MS, RD, CDN)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:M
Last Name:KOLANKOWSKI
Suffix:
Gender:F
Credentials:MS, RD, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 NOTT TER
Mailing Address - Street 2:SUITE 304
Mailing Address - City:SCHENECTADY
Mailing Address - State:NY
Mailing Address - Zip Code:12308-3170
Mailing Address - Country:US
Mailing Address - Phone:518-386-2528
Mailing Address - Fax:
Practice Address - Street 1:107 NOTT TERR
Practice Address - Street 2:SUITE 304
Practice Address - City:SCHENECTADY
Practice Address - State:NY
Practice Address - Zip Code:12308
Practice Address - Country:US
Practice Address - Phone:518-386-2528
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2009-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001735-1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered