Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 233383 | NY |
NPI | 1043337801 |
---|---|
Provider Name | Dr. Kristin Magnuson Nord |
First Address | New York, NY 10010-2622 |
Second Address | New York, NY 10032-3729 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2007 |
Last Update Date | 08/07/2007 |