Provider Demographics
NPI:1457775181
Name:KRISHEN, GUY (DC)
Entity Type:Individual
Prefix:DR
First Name:GUY
Middle Name:
Last Name:KRISHEN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 E TOWNSHIP LINE RD
Mailing Address - Street 2:
Mailing Address - City:UPPER DARBY
Mailing Address - State:PA
Mailing Address - Zip Code:19082-1019
Mailing Address - Country:US
Mailing Address - Phone:610-624-4459
Mailing Address - Fax:610-789-2627
Practice Address - Street 1:115 E TOWNSHIP LINE RD
Practice Address - Street 2:
Practice Address - City:UPPER DARBY
Practice Address - State:PA
Practice Address - Zip Code:19082-1019
Practice Address - Country:US
Practice Address - Phone:610-624-4459
Practice Address - Fax:610-789-2627
Is Sole Proprietor?:No
Enumeration Date:2014-02-17
Last Update Date:2018-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY609196887111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor