Provider Demographics
NPI:1588192975
Name:URBAS, KIRSTYN R
Entity Type:Individual
Prefix:
First Name:KIRSTYN
Middle Name:R
Last Name:URBAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:774 CHRISTIANA RD STE 105
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-4248
Mailing Address - Country:US
Mailing Address - Phone:302-355-0056
Mailing Address - Fax:
Practice Address - Street 1:774 CHRISTIANA RD STE 105
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-4248
Practice Address - Country:US
Practice Address - Phone:856-325-3718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-05-30
Last Update Date:2023-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJXXX213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty