Provider Demographics
NPI:1174685036
Name:VANACORE, KRISTY MARIE
Entity Type:Individual
Prefix:DR
First Name:KRISTY
Middle Name:MARIE
Last Name:VANACORE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:334 UNDERHILL AVE
Mailing Address - Street 2:BUILDING 3
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-4530
Mailing Address - Country:US
Mailing Address - Phone:914-497-8006
Mailing Address - Fax:888-503-4138
Practice Address - Street 1:334 UNDERHILL AVE
Practice Address - Street 2:BUILDING 3
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-4530
Practice Address - Country:US
Practice Address - Phone:914-497-8006
Practice Address - Fax:888-503-4138
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-15
Last Update Date:2013-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017242103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical