Provider Demographics
NPI:1043337801
Name:NORD, KRISTIN MAGNUSON (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISTIN
Middle Name:MAGNUSON
Last Name:NORD
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:30 WATERSIDE PLZ
Mailing Address - Street 2:APT. 25E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10010-2622
Mailing Address - Country:US
Mailing Address - Phone:212-684-4409
Mailing Address - Fax:270-588-7138
Practice Address - Street 1:161 FORT WASHINGTON AVE
Practice Address - Street 2:12TH FLOOR, ROOM 1206A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3729
Practice Address - Country:US
Practice Address - Phone:212-305-5317
Practice Address - Fax:212-795-1859
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY233383207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology