Individual
KRISTYN E SOUSOU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
601 ELMWOOD AVE, BOX MED, ROCHESTER, NY 14642-0001
(585) 275-4711
(585) 276-2140
Mailing address
601 ELMWOOD AVE, BOX MED, ROCHESTER, NY 14642-0001
(585) 275-4711
(585) 276-2140
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
302806
NY
363LA2200X
Adult Health Nurse Practitioner
Primary
F302806-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02549966
—
NY
Enumeration date
08/04/2006
Last updated
07/05/2023
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