Provider Demographics
NPI:1811636004
Name:DEWEY, KALEY MICHELLE (MS, RDN, CDN)
Entity type:Individual
Prefix:
First Name:KALEY
Middle Name:MICHELLE
Last Name:DEWEY
Suffix:
Gender:F
Credentials:MS, RDN, CDN
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 831
Mailing Address - Street 2:
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:14072-0831
Mailing Address - Country:US
Mailing Address - Phone:716-704-0684
Mailing Address - Fax:716-625-1236
Practice Address - Street 1:1207 DELAWARE AVE STE 114
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14209-1458
Practice Address - Country:US
Practice Address - Phone:716-704-0684
Practice Address - Fax:716-625-1236
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-03
Last Update Date:2025-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010686133VN1006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133VN1006XDietary & Nutritional Service ProvidersDietitian, RegisteredNutrition, Metabolic