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General NPI Number Information
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NPI Number | 1023886041
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Entity Type | Individual
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Provider Name | JENNIFER KISH MHS,PA (ASCP)
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Gender | Female
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Dates
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Enumeration Date | 12/19/2023
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Last Update Date | 12/19/2023
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Provider Practice Location Address
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Address Line | 100 PARK ST
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City | GLENS FALLS
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State | NY
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Zip | 12801-4447
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Country | US
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Telephone | 518-926-3836
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Fax | 518-926-3857
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Provider Business Mailing Address
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Address Line | 226 NELSON AVE
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City | SARATOGA SPRINGS
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State | NY
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Zip | 12866-3419
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Country | US
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Telephone | 617-308-1568
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZP0101X
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Taxonomy Name | Anatomic Pathology Physician
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License Number | 000405-01
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License Number State | NY
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