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Individual

DEBORAH LEADHOLM KRISS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
553 CLINTON AVE, KOINONIA HEALTH CARE, ALBANY, NY 12206-2738
(518) 689-0282
(518) 689-0283
Mailing address
553 CLINTON AVE, KOINONIA HEALTH CARE, ALBANY, NY 12206
(518) 689-0282
(518) 689-0283

Taxonomy

Speciality
Code
Description
License number
State
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
60-139707
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000472214006
BSNENY
NY
01
010ZM1
EMPIRE BLUECROSS
NY
01
090406000031
FIDELIS
01
10022210
CDPHP
NY
01
137306
GHI/HMO
NY
01
3007738
MVP HEALTHCARE
NY
01
5331692
AETNA
NY
Enumeration date
07/11/2006
Last updated
07/08/2009
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