Provider Demographics
NPI:1336367317
Name:YALAMANCHILI, KASTURI SIRISHA (RD)
Entity type:Individual
Prefix:MS
First Name:KASTURI
Middle Name:SIRISHA
Last Name:YALAMANCHILI
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:PO BOX 758997
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21275-0001
Mailing Address - Country:US
Mailing Address - Phone:804-828-0970
Mailing Address - Fax:804-628-0204
Practice Address - Street 1:1250 E.MARSHALL STREET
Practice Address - Street 2:FOOD AND NUTRITION SERVICES
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23298-0294
Practice Address - Country:US
Practice Address - Phone:804-828-0970
Practice Address - Fax:804-628-0921
Is Sole Proprietor?:No
Enumeration Date:2007-04-23
Last Update Date:2008-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered