Provider Demographics
NPI:1689612962
Name:PISTONE, KRISTYN (DPM)
Entity Type:Individual
Prefix:DR
First Name:KRISTYN
Middle Name:
Last Name:PISTONE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 5326
Mailing Address - Street 2:
Mailing Address - City:BRADFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01835-0326
Mailing Address - Country:US
Mailing Address - Phone:978-556-9750
Mailing Address - Fax:978-521-8381
Practice Address - Street 1:62 BROWN STREET
Practice Address - Street 2:SUITE 201
Practice Address - City:HAVERHILL
Practice Address - State:MA
Practice Address - Zip Code:01830
Practice Address - Country:US
Practice Address - Phone:978-556-9750
Practice Address - Fax:978-521-8381
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-02
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2160213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0326721Medicaid
MA405882OtherTUFTS HEALTH PLAN
MAY71081OtherBLLUE CROSS/BLUE SHIELD
MA333480OtherHARVARD PILGRIM HELATHCAR
MA0024366OtherNEIGHBOORHOOD HEALTH PLAN
MAU76264Medicare UPIN
Y75112Medicare ID - Type Unspecified
MAY71081OtherBLLUE CROSS/BLUE SHIELD