| Kyss Med Spa | |
|
203 Elden St Ste 304 Herndon VA 20170-4814 | |
| (703) 463-9620 | |
| Not Available |
| Full Name | Kyss Med Spa |
|---|---|
| Speciality | Clinic/Center |
| Location | 203 Elden St Ste 304, Herndon, Virginia |
| Authorized Official Name and Position | Harpreet Gill (OWNER) |
| Authorized Official Contact | 7034639620 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kyss Med Spa 203 Elden St Ste 304 Herndon VA 20170-4814 Ph: (703) 463-9620 | Kyss Med Spa 203 Elden St Ste 304 Herndon VA 20170-4814 Ph: (703) 463-9620 |
| NPI Number | 1104553213 |
|---|---|
| Provider Enumeration Date | 08/08/2022 |
| Last Update Date | 08/08/2022 |
| Medicare PECOS PAC ID | 4880063254 |
|---|---|
| Medicare Enrollment ID | O20221206002448 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104553213 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
| Provider Name | Nicole Herberger |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1811560972 PECOS PAC ID: 4385049121 Enrollment ID: I20210902001645 |
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