Provider Demographics
NPI:1356592331
Name:MAMMAS, KRIS (DVM)
Entity type:Individual
Prefix:DR
First Name:KRIS
Middle Name:
Last Name:MAMMAS
Suffix:
Gender:M
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:256 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-2522
Mailing Address - Country:US
Mailing Address - Phone:201-437-0100
Mailing Address - Fax:201-437-8774
Practice Address - Street 1:256 BROADWAY
Practice Address - Street 2:
Practice Address - City:BAYONNE
Practice Address - State:NJ
Practice Address - Zip Code:07002-2522
Practice Address - Country:US
Practice Address - Phone:201-437-0100
Practice Address - Fax:201-437-8774
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-08
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ29VI00294400174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian