MEDICARE: KRISTEN ELAINE PARILLO MS

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
1	163WP0808X	Psychiatric/Mental Health Registered Nurse	509504	NY
2	163WP0808X	Psychiatric/Mental Health Registered Nurse	509504-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	509504-1	OTHER	NY	NEW YORK STATE OFFICE OF THE PROFESSIONS

General Provider Information

NPI Number	:	1962874271
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTEN ELAINE PARILLO MS

Provider Business Mailing Address
First Line	:	188 LAKE AVE
Second Line	:
City	:	SARATOGA SPRINGS
State	:	NY
Zip	:	12866-2565
Country	:	US
Telephone Number	:	518-690-6275
Fax Number	:

Provider Business Practice Location Address
First Line	:	188 LAKE AVE
Second Line	:
City	:	SARATOGA SPRINGS
State	:	NY
Zip	:	12866-2565
Country	:	US
Telephone Number	:	518-690-6275
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/26/2015
Last Update Date	:	10/07/2024

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