Kristina Freshour, RD | |
5 Wyndover Woods Ln Apt 1, White Plains, NY 10603-3155 | |
(631) 338-8760 | |
Not Available |
Full Name | Kristina Freshour |
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Gender | Female |
Speciality | Dietitian, Registered |
Location | 5 Wyndover Woods Ln Apt 1, White Plains, New York |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
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1013655976 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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133V00000X | Dietitian, Registered | 86151636 (New York) | Primary |
Provider Name | North Shore - Lij Medical Pc |
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Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1053688572 PECOS PAC ID: 3375701568 Enrollment ID: O20120220000262 |
Mailing Address | Practice Location Address |
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Kristina Freshour, RD 90 State St Ste Office40, Albany, NY 12207-1716 Ph: () - | Kristina Freshour, RD 5 Wyndover Woods Ln Apt 1, White Plains, NY 10603-3155 Ph: (631) 338-8760 |
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