Provider Demographics
NPI:1093814618
Name:COMPA, KRISTEN L (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:L
Last Name:COMPA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:711 TROY SCHENECTADY RD STE 203
Mailing Address - Street 2:
Mailing Address - City:LATHAM
Mailing Address - State:NY
Mailing Address - Zip Code:12110-2461
Mailing Address - Country:US
Mailing Address - Phone:518-782-3700
Mailing Address - Fax:518-782-3799
Practice Address - Street 1:942A ROUTE 146
Practice Address - Street 2:
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-3614
Practice Address - Country:US
Practice Address - Phone:518-371-8000
Practice Address - Fax:518-371-5338
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2018-01-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY126177208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY200490OtherSENIOR WHOLE HEALTH
NY061211000232OtherFIDELIS
NY7275708OtherAETNA
NY10097435OtherCDPHP
NY92102OtherGHI/HMO
NY645X42OtherEMPIRE BC
NY000415465001OtherBSNENY
NY382645OtherMVP
NY02659098Medicaid