Healthcare Provider Details

I. General information

NPI: 1235041450
Provider Name (Legal Business Name): KRISTIN DUYCK FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2026
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

234 E 149TH ST
BRONX NY
10451-5504
US

IV. Provider business mailing address

3086 31ST ST APT 1R
ASTORIA NY
11102-1868
US

V. Phone/Fax

Practice location:
  • Phone: 718-579-5161
  • Fax:
Mailing address:
  • Phone: 503-828-8418
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number361000
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: