Healthcare Provider Details

I. General information

NPI: 1659221562
Provider Name (Legal Business Name): KRIS-TAL CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2026
Last Update Date: 01/30/2026
Certification Date: 01/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 SCOTCHTOWN AVE
GOSHEN NY
10924-1631
US

IV. Provider business mailing address

1401 VALLEY RD STE 4
WAYNE NJ
07470-2074
US

V. Phone/Fax

Practice location:
  • Phone: 888-822-7428
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251F00000X
TaxonomyHome Infusion Agency
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QI0500X
TaxonomyInfusion Therapy Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MARLIYNN RECINE
Title or Position: DIRECTOR, RCM
Credential:
Phone: 888-822-7428