Doctor Name: | MS. KRISTIN M ORRICO |
NPI Number: | 1003035197 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | RPA-C |
License Number: | 011235 |
Business Practice Address: | 3051 Long Beach Rd Suite 6 Oceanside, NY - 115723240 |
Business Phone Number: | 5167645142 |
Business Fax Number: | |
Mailing Address: | 72 Barry Ln, SYOSSET |
State: | NY |
Postal Code: | 11791 |
Phone Number: | 5162367498 |
Fax Number: | |
NPI Enumeration Date: | 04/25/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 011235 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |