Provider Demographics
NPI:1023037355
Name:KINGSTON, WILLIAM J (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:J
Last Name:KINGSTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:199 PARRISH ST
Mailing Address - Street 2:
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-1788
Mailing Address - Country:US
Mailing Address - Phone:585-394-6811
Mailing Address - Fax:585-394-7497
Practice Address - Street 1:199 PARRISH ST
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-1788
Practice Address - Country:US
Practice Address - Phone:585-394-6811
Practice Address - Fax:585-394-7497
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2012-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1456802084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00717657Medicaid
NY00717657Medicaid
NYB72499Medicare UPIN