Provider Demographics
NPI:1174091201
Name:GREY, KATHRYN LORI (MPH, RD)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:LORI
Last Name:GREY
Suffix:
Gender:F
Credentials:MPH, RD
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:LORI
Other - Last Name:CLEFFI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MPH, RD
Mailing Address - Street 1:427 SEMMES ST
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:RI
Mailing Address - Zip Code:02842-4715
Mailing Address - Country:US
Mailing Address - Phone:973-978-3967
Mailing Address - Fax:
Practice Address - Street 1:18TH MEDICAL GROUP, UNIT 5142
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96368-5142
Practice Address - Country:US
Practice Address - Phone:804-370-3967
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-11-07
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered