Provider Demographics
NPI:1700982337
Name:CUENCA-SISKO, KRISTYL M (RPA-C)
Entity type:Individual
Prefix:MRS
First Name:KRISTYL
Middle Name:M
Last Name:CUENCA-SISKO
Suffix:
Gender:F
Credentials:RPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 E 36TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-3402
Mailing Address - Country:US
Mailing Address - Phone:212-686-6321
Mailing Address - Fax:
Practice Address - Street 1:116 E 36TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-3402
Practice Address - Country:US
Practice Address - Phone:212-686-6321
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-14
Last Update Date:2012-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007173363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant