Provider Demographics
NPI:1346501582
Name:ENGELSTAD, KRISTIN MARIE (MS)
Entity Type:Individual
Prefix:MS
First Name:KRISTIN
Middle Name:MARIE
Last Name:ENGELSTAD
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:630 W 168TH ST
Mailing Address - Street 2:COLULMBIA UNIVERSITY P&S 4-423
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3725
Mailing Address - Country:US
Mailing Address - Phone:212-305-6834
Mailing Address - Fax:212-342-2893
Practice Address - Street 1:630 W 168TH ST
Practice Address - Street 2:COLUMBIA UNIVERSITY P&S 4-423
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3725
Practice Address - Country:US
Practice Address - Phone:212-305-6834
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-05
Last Update Date:2012-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS