Provider Demographics
NPI:1689410920
Name:YISRAEL, KAYELA NIEMAH (RDN, LDN)
Entity type:Individual
Prefix:
First Name:KAYELA
Middle Name:NIEMAH
Last Name:YISRAEL
Suffix:
Gender:F
Credentials:RDN, LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1572 CHESTER PIKE # 1032
Mailing Address - Street 2:
Mailing Address - City:FOLCROFT
Mailing Address - State:PA
Mailing Address - Zip Code:19032-1006
Mailing Address - Country:US
Mailing Address - Phone:917-405-8571
Mailing Address - Fax:
Practice Address - Street 1:1572 CHESTER PIKE # 1032
Practice Address - Street 2:
Practice Address - City:FOLCROFT
Practice Address - State:PA
Practice Address - Zip Code:19032-1006
Practice Address - Country:US
Practice Address - Phone:917-405-8571
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-05
Last Update Date:2024-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADN008616133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered