Provider Demographics
NPI:1578823555
Name:GO, KRISTINA M (MD)
Entity Type:Individual
Prefix:
First Name:KRISTINA
Middle Name:M
Last Name:GO
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Gender:F
Credentials:MD
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Mailing Address - Street 1:251 SALINA MEADOWS PKWY
Mailing Address - Street 2:STE 100
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13212-4516
Mailing Address - Country:US
Mailing Address - Phone:315-464-2000
Mailing Address - Fax:315-464-2010
Practice Address - Street 1:4900 BROAD ROAD
Practice Address - Street 2:STE 2B NORTH
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13215
Practice Address - Country:US
Practice Address - Phone:315-492-5036
Practice Address - Fax:315-492-5477
Is Sole Proprietor?:No
Enumeration Date:2012-05-23
Last Update Date:2020-09-23
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Provider Licenses
StateLicense IDTaxonomies
FL17318208600000X
NY307194208C00000X, 208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery