Individual
DR. MICHAEL E KISSIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH.D.
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
009369
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000207890201
HEALTH PLUS PROV.#
NY
01
—
009369
LICENCE #
NY
05
—
01499105
—
NY
01
—
4571094
AETNA PROV. #
NY
01
—
654049
UHC
NY
01
—
7348273
GHI PROV #
NY
01
—
V41631
BLUE CROSS BLUE SHEILD ID
NY
Enumeration date
11/29/2006
Last updated
05/10/2008
Update your record
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