Gustafson, Kristin A

Gustafson, Kristin A is an individual health care provider with primary practice located at 25 S 9Th St Fl 1 , Philadelphia PA 19107. She recently has only one registered license in Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation, which is considered as her primary health care specialty. Gustafson, Kristin A can be contacted via phone (215) 955-1200.

Contact Information

Primary practice address
25 S 9Th St Fl 1 Philadelphia PA 19107
Phone: (215) 955-1200
Fax: (215) 923-6808
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X MD225827 Massachusetts
Allopathic & Osteopathic Physicians / Physical Medicine & Rehabilitation 208100000X OS014841 Pennsylvania

Profile Details

NPI number 1447222765
LBN Legal business name Gustafson, Kristin A
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 2nd, 2006
Last updated Dec 19th, 2018 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1447222765 NPPES
Pennsylvania MEDICAID 102334750

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