Basic Information
| Provider Information | |||||||||
| NPI: | 1205261641 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FIELDS | ||||||||
| FirstName: | KRISTEN | ||||||||
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| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5 PLAINSBORO RD STE 390 | ||||||||
| Address2: | |||||||||
| City: | PLAINSBORO | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 085361916 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6094974371 | ||||||||
| FaxNumber: | 6094974379 | ||||||||
| Practice Location | |||||||||
| Address1: | 200 GARDEN CITY PLZ | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | GARDEN CITY | ||||||||
| State: | NY | ||||||||
| PostalCode: | 115303301 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5166636400 | ||||||||
| FaxNumber: | 5163078840 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/04/2013 | ||||||||
| LastUpdateDate: | 12/20/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/20/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | P87315 | NY | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
No ID Information.