Individual
MR. STEPHEN JOHN KINGSTON II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
ROUTE 96, ROMULUS, NY 14541-0400
(607) 869-5111
Mailing address
1730 PENFIELD RD, APT 85, PENFIELD, NY 14526-2148
(585) 264-1454
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
008910
NY
Other
Enumeration date
03/25/2007
Last updated
07/09/2007
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