Healthcare Provider Details

I. General information

NPI: 1912503913
Provider Name (Legal Business Name): KRISTI-ANN DEUTSCH PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2020
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2035 LAKEVILLE RD STE 206
NEW HYDE PARK NY
11040-1661
US

IV. Provider business mailing address

2035 LAKEVILLE RD STE 206
NEW HYDE PARK NY
11040-1661
US

V. Phone/Fax

Practice location:
  • Phone: 516-299-6434
  • Fax:
Mailing address:
  • Phone: 516-299-6434
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number026119
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: