Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kelly Danielle Tahlor, RDN, CDN

Individual provider Registered Dietitian · NPI 1275231433

Kelly Danielle Tahlor, RDN, CDN is a Registered Dietitian OR Nutrition Professional in Centereach, New York. Qualified in 2021, 5 years ago. Practices with Stony Brook Surgical Associates University Faculty Practice Corporati, a 102-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
5
Licensed in
NY
In the registry since
2023
What do these letters mean?
RDN — Registered Dietitian Nutritionist
The current title for a registered dietitian.

See every abbreviation used in this directory →

Practice location Address checks out

23 S Howell Ave Ste D
Centereach, NY 11720-4445
Phone: (631) 444-2274
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Registered Dietitian (primary) Taxonomy 133V00000X · Licence 011259 (NY)

Record details

NPI number1275231433
Entity typeIndividual (Type 1)
GenderFemale
Credentials RDN , CDN
Sole proprietorNo
NPI enumeratedFebruary 17, 2023
Last updated in NPPESFebruary 17, 2023
Certification dateDecember 6, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyREGISTERED DIETITIAN OR NUTRITION PROFESSIONAL
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Stony Brook Surgical Associates University Faculty Practice Corporati — 102 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Centereach