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General NPI Number Information
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NPI Number | 1457837148
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Entity Type | Individual
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Provider Name | KRISTOFFER FLORES PHYSICIAN ASSISTANT
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Gender | Male
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Dates
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Enumeration Date | 07/16/2018
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Last Update Date | 07/16/2018
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Provider Practice Location Address
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Address Line | 8900 VAN WYCK EXPY
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City | RICHMOND HILL
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State | NY
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Zip | 11418-2897
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Country | US
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Telephone | 917-703-2425
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Fax |
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Provider Business Mailing Address
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Address Line | 10127 103RD ST
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City | OZONE PARK
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State | NY
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Zip | 11416-2630
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Country | US
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Telephone | 917-703-2425
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 22034
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License Number State | NY
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