Healthcare Provider Details

I. General information

NPI: 1386281483
Provider Name (Legal Business Name): KRISTIN NICOLE HARRINGTON RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2019
Last Update Date: 09/29/2026
Certification Date: 12/08/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29 BUFFALO AVE APT 8
ISLIP NY
11751-2316
US

IV. Provider business mailing address

29 BUFFALO AVE APT 8
ISLIP NY
11751-2316
US

V. Phone/Fax

Practice location:
  • Phone: 631-294-2638
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number6766511
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: