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General NPI Number Information
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NPI Number | 1972461101
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Entity Type | Organization
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Legal Business Name | KYNDRED CLINICAL LLC
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Dates
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Enumeration Date | 01/15/2026
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Last Update Date | 01/15/2026
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Provider Practice Location Address
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Address Line | 109 N 12TH ST STE 704
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City | BROOKLYN
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State | NY
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Zip | 11249-1002
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Country | US
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Telephone | 347-201-0388
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Fax |
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Provider Business Mailing Address
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Address Line | 224 W 35TH ST STE 500
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City | NEW YORK
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State | NY
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Zip | 10001-2538
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PC OWNER/ CHIEF CLINICAL OFFICER
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Name | TESIAH COLEMAN
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Credential | NP
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Telephone | 508-274-9434
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363LW0102X
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Taxonomy Name | Women's Health Nurse Practitioner
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License Number |
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License Number State |
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