Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207N00000X | Dermatologist | 186933 | NY |
Y | 207N00000X | Dermatologist | D57715 | MD |
N | 207ND0900X | Dermatopathologist | 186933 | NY |
N | 207ND0900X | Dermatopathologist | D57715 | MD |
NPI | 1407951361 |
---|---|
Provider Name | Stephen Joseph Krivda |
First Address | Kensington, MD 20895-3612 |
Second Address | Washington, DC 20307-0003 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2006 |
Last Update Date | 15/01/2020 |