| Doctor Name: | MRS. KRYSTELLE M MAKHARIA |
| NPI Number: | 1063793735 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | NPP |
| License Number: | 401423 |
| Business Practice Address: | 1387 Fairport Road, Suite 1000 Fairport, NY - 14450 |
| Business Phone Number: | 5857700029 |
| Business Fax Number: | |
| Mailing Address: | 1387 Fairport Rd Ste 1000d, FAIRPORT |
| State: | NY |
| Postal Code: | 144502004 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 09/07/2011 |
| NPI Last Update Date: | 01/04/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LP0808X |
| License Number: | 401423 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Psych/Mental Health |
| Taxonomy Definition: | |