Provider Demographics
NPI:1588208466
Name:MORTZFIELD, KRISTINA ANNE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:KRISTINA
Middle Name:ANNE
Last Name:MORTZFIELD
Suffix:
Gender:F
Credentials:PA-C
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Other - Credentials:
Mailing Address - Street 1:333 E 56TH ST APT 5A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10022-3759
Mailing Address - Country:US
Mailing Address - Phone:248-917-4703
Mailing Address - Fax:
Practice Address - Street 1:333 E 56TH ST APT 5A
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10022-3759
Practice Address - Country:US
Practice Address - Phone:248-917-4703
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-04
Last Update Date:2020-01-21
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant