Provider Demographics
NPI:1407061815
Name:CHRISTENSEN, KRISTIN GEISSER (MD)
Entity Type:Individual
Prefix:
First Name:KRISTIN
Middle Name:GEISSER
Last Name:CHRISTENSEN
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 1:3701 MARKET ST
Mailing Address - Street 2:6TH FLOOR, SUITE 640
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-5502
Mailing Address - Country:US
Mailing Address - Phone:215-662-2250
Mailing Address - Fax:215-615-3995
Practice Address - Street 1:3701 MARKET ST
Practice Address - Street 2:6TH FLOOR, SUITE 640
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-5502
Practice Address - Country:US
Practice Address - Phone:215-662-2250
Practice Address - Fax:215-615-3995
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2012-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT190395207R00000X
PAMD439833207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine