Provider Demographics
NPI:1700401981
Name:RINALDI, KRISTEN M (PA-C)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:M
Last Name:RINALDI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:159 BIRCHWOOD RD
Mailing Address - Street 2:
Mailing Address - City:OLD TAPPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07675-6810
Mailing Address - Country:US
Mailing Address - Phone:201-321-0486
Mailing Address - Fax:
Practice Address - Street 1:177 FORT WASHINGTON AVENUE
Practice Address - Street 2:5HN
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032
Practice Address - Country:US
Practice Address - Phone:212-305-2500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-12
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical