Provider Demographics
NPI:1285688341
Name:KRISTYN PISTONE
Entity Type:Organization
Organization Name:KRISTYN PISTONE
Other - Org Name:MERRIMACK VALLEY FOOTCARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KRISTYN
Authorized Official - Middle Name:
Authorized Official - Last Name:PISTONE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:978-556-9750
Mailing Address - Street 1:62 BROWN STREET
Mailing Address - Street 2:SUITE 201
Mailing Address - City:HAVERHILL
Mailing Address - State:MA
Mailing Address - Zip Code:01830-6700
Mailing Address - Country:US
Mailing Address - Phone:978-556-9750
Mailing Address - Fax:978-521-8381
Practice Address - Street 1:62 BROWN STREET
Practice Address - Street 2:SUITE 201
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830-6700
Practice Address - Country:US
Practice Address - Phone:978-556-9750
Practice Address - Fax:978-521-8381
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2013-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0326721Medicaid
MA694010OtherTUFTS HEALTH PLAN
MAY71081OtherBLUE CROSS/BLUE SHIELD
MAY71081OtherBLUE CROSS/BLUE SHIELD