Individual
KRISTEN CORRINE RISOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1111 AMSTERDAM AVE # CLARK7, NEW YORK, NY 10025-1716
(212) 523-4000
Mailing address
1111 AMSTERDAM AVE # CLARK7, NEW YORK, NY 10025-1716
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
018318
NY
Other
Enumeration date
12/11/2014
Last updated
01/05/2015
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