| Doctor Name: | MR. STEPHEN JOHN KINGSTON |
| NPI Number: | 1316064124 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA-C |
| License Number: | 008910 |
| Business Practice Address: | Route 96 Romulus, NY - 145410400 |
| Business Phone Number: | 6078695111 |
| Business Fax Number: | |
| Mailing Address: | 1730 Penfield Rd, Apt 85 PENFIELD |
| State: | NY |
| Postal Code: | 145262148 |
| Phone Number: | 5852641454 |
| Fax Number: | |
| NPI Enumeration Date: | 03/25/2007 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 008910 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |