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General NPI Number Information
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NPI Number | 1417258880
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Entity Type | Individual
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Provider Name | CORINNE P KRIST D.O.
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Gender | Female
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Dates
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Enumeration Date | 11/16/2010
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 275 THOMAS INDIAN SCHOOL DR
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City | IRVING
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State | NY
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Zip | 14081-9341
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Country | US
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Telephone | 716-532-5582
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Fax | 716-242-6344
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Provider Business Mailing Address
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Address Line | 987 R C HOAG DR
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City | SALAMANCA
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State | NY
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Zip | 14779-1365
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Country | US
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Telephone | 716-945-5894
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Fax | 716-242-6345
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 262755
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 262755
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License Number State | NY
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