Individual
CAROLINE J KISTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
593 EDDY ST, PROVIDENCE, RI 02903-4970
(401) 444-6195
(401) 444-6378
Mailing address
117 ELLENFIELD ST STE 101, PROVIDENCE, RI 02905-4541
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD18829
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110079849A
—
MA
Enumeration date
05/21/2008
Last updated
12/06/2022
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