Individual
KELLY JEAN MELNIK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
REGISTERED DIETITIAN
Contact information
Practice address
297 KNOLLWOOD RD STE 304, WHITE PLAINS, NY 10607-1849
(914) 693-2174
Mailing address
1 OLD VILLAGE LN, KATONAH, NY 10536-1123
(914) 584-8561
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
86105792
COMMISSION ON DIETETIC REGISTRATION
—
Enumeration date
03/26/2021
Last updated
03/26/2021
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