Individual
IN KIO MAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, CDN
Contact information
Practice address
250 WEST 64TH STREET, NEW YORK, NY 10023
(212) 769-6313
(212) 769-7825
Mailing address
250 WEST 64TH STREET, NEW YORK, NY 10023
(212) 769-6313
(212) 769-7825
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
009350-01
NY
133V00000X
Registered Dietitian
1068495
NY
Other
Enumeration date
04/29/2021
Last updated
09/09/2025
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