Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 2765171 | NY |
N | 111NI0900X | Internist | 2765171 | NY |
Y | 207RC0000X | Internist - Cardiovascular Disease | 2765171 | NY |
N | 207RC0001X | Clinical Cardiac Electrophysiologist | 2765171 | NY |
NPI | 1295009348 |
---|---|
Provider Name | Krysthel Engstrom |
First Address | New York, NY 10029-6504 |
Second Address | New York, NY 10019 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/03/2012 |
Last Update Date | 21/06/2018 |