Provider Demographics
NPI:1588540348
Name:REACH, KYLIE (RDN, CDN)
Entity type:Individual
Prefix:
First Name:KYLIE
Middle Name:
Last Name:REACH
Suffix:
Gender:F
Credentials:RDN, CDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:46 PINE ST
Mailing Address - Street 2:
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-5625
Mailing Address - Country:US
Mailing Address - Phone:716-730-0175
Mailing Address - Fax:
Practice Address - Street 1:46 PINE ST
Practice Address - Street 2:
Practice Address - City:NORTH TONAWANDA
Practice Address - State:NY
Practice Address - Zip Code:14120-5625
Practice Address - Country:US
Practice Address - Phone:716-730-0175
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-14
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS3378133V00000X
IL164.022488133V00000X
NY012906133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered