Basic Information
Provider Information
NPI: 1376572297
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SZABO
FirstName: KRISTEN
MiddleName: MARIAH
NamePrefix:  
NameSuffix:  
Credential: PA
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
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Mailing Information
Address1: 110 S BEDFORD RD
Address2: CAREMOUNT MEDICAL PC
City: MOUNT KISCO
State: NY
PostalCode: 105493446
CountryCode: US
TelephoneNumber: 9142411050
FaxNumber: 9142421516
Practice Location
Address1: 6734 ROUTE 9
Address2:  
City: RHINEBECK
State: NY
PostalCode: 125723724
CountryCode: US
TelephoneNumber: 8452315600
FaxNumber: 8452026700
Other Information
ProviderEnumerationDate: 07/02/2006
LastUpdateDate: 11/23/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363AM0700X006880NYY Physician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical

No ID Information.


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