Provider Demographics
NPI:1568894558
Name:LAO, KRISELLE MARIS NOBLESA (MD)
Entity Type:Individual
Prefix:MS
First Name:KRISELLE MARIS
Middle Name:NOBLESA
Last Name:LAO
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 1:9D, GREENRICH M.,
Mailing Address - Street 2:LOURDES ST., ORTIGAS CENTER
Mailing Address - City:PASIG
Mailing Address - State:PHILIPPINES
Mailing Address - Zip Code:001605
Mailing Address - Country:PH
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:9D, GREENRICH M.,
Practice Address - Street 2:LOURDES ST., ORTIGAS CENTER
Practice Address - City:PASIG
Practice Address - State:PHILIPPINES
Practice Address - Zip Code:001605
Practice Address - Country:PH
Practice Address - Phone:632-633-9166
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-08-01
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN61465207ZP0104X, 207ZP0102X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No207ZP0104XAllopathic & Osteopathic PhysiciansPathologyChemical Pathology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program