Provider Demographics
NPI:1043787104
Name:PRENDERGAST, KATELYNN FAITH (RDN)
Entity type:Individual
Prefix:MS
First Name:KATELYNN
Middle Name:FAITH
Last Name:PRENDERGAST
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:MS
Other - First Name:KATELYNN
Other - Middle Name:FAITH
Other - Last Name:ARNDT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9568 DARIEN RD
Mailing Address - Street 2:
Mailing Address - City:WEST FALLS
Mailing Address - State:NY
Mailing Address - Zip Code:14170-9611
Mailing Address - Country:US
Mailing Address - Phone:702-533-0217
Mailing Address - Fax:
Practice Address - Street 1:2780 DELAWARE AVE STE 2790
Practice Address - Street 2:
Practice Address - City:KENMORE
Practice Address - State:NY
Practice Address - Zip Code:14217-2748
Practice Address - Country:US
Practice Address - Phone:716-931-9037
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-26
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty