Provider Demographics
NPI:1215105549
Name:ESTONY, KATHLEEN A (RD)
Entity type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:A
Last Name:ESTONY
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 GENUNG CT
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JCT
Mailing Address - State:NY
Mailing Address - Zip Code:12533-6110
Mailing Address - Country:US
Mailing Address - Phone:845-226-2096
Mailing Address - Fax:
Practice Address - Street 1:ST LUKES DIALYSIS CENTER
Practice Address - Street 2:4 CORWIN CT
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550
Practice Address - Country:US
Practice Address - Phone:845-562-7711
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-20
Last Update Date:2008-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000622133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered