Individual
KINGA KISZKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O
Contact information
Practice address
1468 MADISON AVE, NEW YORK, NY 10029-6508
(212) 241-6500
Mailing address
PO BOX 28082, NEW YORK, NY 10087-8082
(212) 987-3100
(212) 731-5210
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
284443
NY
207QG0300X
Geriatric Medicine (Family Medicine) Physician
284443
NY
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
284443
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05348912
—
NY
Enumeration date
03/05/2015
Last updated
02/20/2020
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