Healthcare Provider Details

I. General information

NPI: 1730012063
Provider Name (Legal Business Name): KRISTI BEHL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2026
Last Update Date: 06/05/2026
Certification Date: 06/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 LONGWOOD RD
MIDDLE ISLAND NY
11953-2045
US

IV. Provider business mailing address

12 GEORGE ST
EAST PATCHOGUE NY
11772-6205
US

V. Phone/Fax

Practice location:
  • Phone: 631-924-0008
  • Fax:
Mailing address:
  • Phone: 631-921-4451
  • Fax: 631-921-4451

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: