Individual
KRISTOFER KEDAR PETTWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
405300000X
Prevention Professional
Primary
19393832
NY
Other
Enumeration date
07/23/2022
Last updated
07/23/2022
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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