Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 287829 | NY |
NPI | 1003176611 |
---|---|
Provider Name | Kristina Piastro |
First Address | New York, NY 10010-3412 |
Second Address | New York, NY 10016-6402 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/05/2012 |
Last Update Date | 24/10/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
287829 | STATE LICENSE (01) | NY |
287829 | STATE MEDICAL LICENSE (01) | NY |