Provider Demographics
NPI:1891198909
Name:MACELHINNEY, KERI LYNN (RD, CDN, CLT)
Entity Type:Individual
Prefix:MRS
First Name:KERI LYNN
Middle Name:
Last Name:MACELHINNEY
Suffix:
Gender:F
Credentials:RD, CDN, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 189
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:NY
Mailing Address - Zip Code:10512-0189
Mailing Address - Country:US
Mailing Address - Phone:845-803-0226
Mailing Address - Fax:
Practice Address - Street 1:42 LAKE AVENUE EXT STE 172
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06811-5279
Practice Address - Country:US
Practice Address - Phone:845-216-3858
Practice Address - Fax:845-282-8362
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-02
Last Update Date:2024-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007981-1133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered