MRS. KRISTIN ELIZABETH GRAHAM PA-C NPI 1316209703

NPI Information

NPI: 1316209703
Provider Name: MRS. KRISTIN ELIZABETH GRAHAM, PA-C
Classification: Physician Assistant - 363AS0400X
Entity Type: Individual

Specialization: Surgical

PECOS Registration: Yes

Address:
45 READE PL
POUGHKEEPSIE, NY
ZIP 12601
Phone: (845) 437-3152
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MRS. Kristin Elizabeth Graham, PA-C is a surgical physician assistant in Poughkeepsie, NY with 12 years of experience. MRS. Kristin Elizabeth Graham, PA-C NPI is 1316209703. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

45 READE PL
POUGHKEEPSIE, NY
ZIP 12601-947
Phone: (845) 437-3152

The NPI 1316209703 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/12/2012 and was last updated on 11/8/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AS0400X	Physician Assistant	Surgical	015670	NEW YORK	Yes
2	363A00000X	Physician Assistant		015670	NEW YORK	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	03501186	MEDICAID	NEW YORK

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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