Individual
KATHLEEN M CRISAFULLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
113 HOLLAND AVE, ALBANY, NY 12208-3410
(518) 626-5608
Mailing address
113 HOLLAND AVE, ALBANY, NY 12208-3410
(518) 626-5608
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
193247
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01529551
—
NY
Enumeration date
06/29/2006
Last updated
09/21/2018
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