Individual
KIRA SY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LDN, IBCLC
Contact information
Practice address
1500 CHESTNUT ST # 1652, PHILADELPHIA, PA 19102-2737
(215) 380-5904
Mailing address
1500 CHESTNUT ST # 1652, PHILADELPHIA, PA 19102-2737
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DN006868
PA
174N00000X
Lactation Consultant (Non-RN)
L-157524
—
Other
Enumeration date
09/30/2019
Last updated
05/05/2022
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