Provider Demographics
NPI:1073717161
Name:MISTRY, KIRTIDA (MB BCH, DCH, MRCPCH)
Entity Type:Individual
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First Name:KIRTIDA
Middle Name:
Last Name:MISTRY
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Gender:F
Credentials:MB BCH, DCH, MRCPCH
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Mailing Address - Street 1:111 MICHIGAN AVE NW
Mailing Address - Street 2:CHILDREN'S NATIONAL MEDICAL CENTER, DEPT. OF NEPHROLOGY
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2916
Mailing Address - Country:US
Mailing Address - Phone:202-476-5058
Mailing Address - Fax:
Practice Address - Street 1:111 MICHIGAN AVE NW
Practice Address - Street 2:CHILDREN'S NATIONAL MEDICAL CENTER, DEPT. OF NEPHROLOGY
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2916
Practice Address - Country:US
Practice Address - Phone:202-476-5058
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-12
Last Update Date:2009-09-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA850262080P0210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology