Provider Demographics
NPI:1720325020
Name:BUCK, KRISTEN KATYA (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:KATYA
Last Name:BUCK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:901 MARCON BLVD
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18109-9512
Mailing Address - Country:US
Mailing Address - Phone:484-464-3657
Mailing Address - Fax:610-596-2686
Practice Address - Street 1:901 MARCON BLVD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18109-9512
Practice Address - Country:US
Practice Address - Phone:484-464-3657
Practice Address - Fax:610-596-2686
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-08
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD417652207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine