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Individual
KIRSTEN DISCEPOLA
Active
Individual
KIRSTEN DISCEPOLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
25MD00322300
NJ
213E00000X
Podiatrist
65 P80778
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0451363
—
NJ
Enumeration date
07/04/2011
Last updated
04/04/2017
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