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Individual

KRISTY CECILE BEAUHARNAIS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
1825 EASTCHESTER RD, BRONX, NY 10461-2301
(718) 904-2000
Mailing address
1825 EASTCHESTER RD, BRONX, NY 10461-2301

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
025413
NY
363AM0700X
Medical Physician Assistant
025413
CT
363AM0700X
Medical Physician Assistant
Primary
025413
NY

Other

Enumeration date
10/18/2020
Last updated
02/23/2022
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