Healthcare Provider Details

I. General information

NPI: 1790617538
Provider Name (Legal Business Name): KRISTINA PAGAN PHLEBOTOMIST
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2026
Last Update Date: 06/03/2026
Certification Date: 06/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 CEDAR LN APT A1
OSSINING NY
10562-2431
US

IV. Provider business mailing address

42 CEDAR LN APT A1
OSSINING NY
10562-2431
US

V. Phone/Fax

Practice location:
  • Phone: 631-984-1441
  • Fax:
Mailing address:
  • Phone: 631-984-1441
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number9377430951KP
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: