Provider Demographics
NPI:1649017542
Name:NUTRITION WITH KYRA TYWANICK RDN
Entity type:Organization
Organization Name:NUTRITION WITH KYRA TYWANICK RDN
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:REGISTERED DIETITIAN
Authorized Official - Prefix:
Authorized Official - First Name:KYRA
Authorized Official - Middle Name:
Authorized Official - Last Name:TYWANICK
Authorized Official - Suffix:
Authorized Official - Credentials:RDN
Authorized Official - Phone:908-894-4561
Mailing Address - Street 1:21 FIELDSTONE DR
Mailing Address - Street 2:
Mailing Address - City:CLINTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08809-1390
Mailing Address - Country:US
Mailing Address - Phone:908-894-4561
Mailing Address - Fax:
Practice Address - Street 1:21 FIELDSTONE DR
Practice Address - Street 2:
Practice Address - City:CLINTON
Practice Address - State:NJ
Practice Address - Zip Code:08809-1390
Practice Address - Country:US
Practice Address - Phone:908-894-4561
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-09
Last Update Date:2024-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty