Provider Demographics
NPI:1093894149
Name:KISSIN, ESTHER (MD)
Entity Type:Individual
Prefix:
First Name:ESTHER
Middle Name:
Last Name:KISSIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 CONTINENTAL AVE
Mailing Address - Street 2:SUITE 1H
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-5266
Mailing Address - Country:US
Mailing Address - Phone:718-575-0909
Mailing Address - Fax:718-575-2224
Practice Address - Street 1:20 CONTINENTAL AVE
Practice Address - Street 2:SUITE 1H
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375-5266
Practice Address - Country:US
Practice Address - Phone:718-575-0909
Practice Address - Fax:718-575-2224
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY161104207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00914714Medicaid
NY00914714Medicaid
NYB16249Medicare UPIN