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NPI Code Detail

MEDICARE: DANIELLE KINSMAN

MEDICARE:   DANIELLE  KINSMAN
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
1252Y00000XEarly Intervention Provider Agency988466151NY

General Provider Information

NPI Number : 1295109692
Entity Type Code : Individual
Provider Name (Legal Business Name) : DANIELLE KINSMAN
Provider Business Mailing Address
First Line : 1007 EDGEGROVE AVE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10309-2204
Country : US
Telephone Number : 718-356-3342
Fax Number :
Provider Business Practice Location Address
First Line : 1007 EDGEGROVE AVENUE
Second Line :
City : STATEN ISLAND
State : NY
Zip : 10309
Country : US
Telephone Number : 718-356-3342
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/23/2015
Last Update Date : 11/23/2015

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Directions to “ DANIELLE KINSMAN ” Practice Location

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