Provider Demographics
NPI:1881739928
Name:MISKEY, KRISTEN R (PT)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:R
Last Name:MISKEY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 RAILROAD MILLS RD
Mailing Address - Street 2:
Mailing Address - City:PITTSFORD
Mailing Address - State:NY
Mailing Address - Zip Code:14534-4162
Mailing Address - Country:US
Mailing Address - Phone:585-586-7928
Mailing Address - Fax:
Practice Address - Street 1:5415 N BLOOMFIELD RD
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-7964
Practice Address - Country:US
Practice Address - Phone:585-394-9510
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-20
Last Update Date:2019-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY022906-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
7963576OtherAETNA
P030122906OtherBLUE CHOICE
022906OtherMONROE PLAN
P030122906OtherBLUE CROSS BLUE SHIELD
P030122906OtherRIPA
109620FTOtherPREFERRED CARE