MEDICARE: KRISTINA NALINI DINALLY AGACNP-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LA2100X	Acute Care Nurse Practitioner	431820	NY

General Provider Information

NPI Number	:	1265027676
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTINA NALINI DINALLY AGACNP-BC

Provider Business Mailing Address
First Line	:	635 E 22ND ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-1101
Country	:	US
Telephone Number	:	917-771-1516
Fax Number	:

Provider Business Practice Location Address
First Line	:	635 E 22ND ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-1101
Country	:	US
Telephone Number	:	917-771-1516
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/08/2021
Last Update Date	:	03/08/2021

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