Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0200X | Critical Care Medicine | 25MA06455300 | NJ |
N | 207RP1001X | Pulmonary Disease | 25MA06455300 | NJ |
N | 207RS0012X | Sleep Medicine | 25MA06455300 | NJ |
NPI | 1043305493 |
---|---|
Provider Name | Dr. Kristin Gail Fless |
First Address | South Orange, NJ 07079-1136 |
Second Address | Livingston, NJ 07039-5672 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/10/2006 |
Last Update Date | 31/07/2007 |