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NPI Code Detail

MEDICARE: DR. KRISTIN ELISA JANSON D.P.M.

MEDICARE:  DR. KRISTIN ELISA JANSON  D.P.M.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1213E00000XPodiatristN004687NY

General Provider Information

NPI Number : 1104802081
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KRISTIN ELISA JANSON D.P.M.
Provider Business Mailing Address
First Line : 185 MADISON AVE RM 802
Second Line :
City : NEW YORK
State : NY
Zip : 10016-0020
Country : US
Telephone Number : 212-689-9388
Fax Number : 212-689-0195
Provider Business Practice Location Address
First Line : 185 MADISON AVE RM 802
Second Line :
City : NEW YORK
State : NY
Zip : 10016-0020
Country : US
Telephone Number : 212-689-9388
Fax Number : 212-689-0195
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/21/2005
Last Update Date : 02/07/2019

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Directions to “ DR. KRISTIN ELISA JANSON D.P.M.” Practice Location

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