Individual
KRISTIN AYN CARMODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, MHPE
Contact information
Practice address
2 PETER COOPER RD APT 14C, NEW YORK, NY 10010-6727
(917) 783-2711
(616) 975-9824
Mailing address
2 PETER COOPER RD APT 14C, NEW YORK, NY 10010-6727
(917) 783-2711
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
045259
CT
207P00000X
Emergency Medicine Physician
235229
MA
207P00000X
Emergency Medicine Physician
Primary
241810
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2159325
—
MA
Enumeration date
06/27/2007
Last updated
06/07/2021
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