Provider Demographics
NPI:1760838858
Name:CETNER, KRISSA (NP)
Entity type:Individual
Prefix:MS
First Name:KRISSA
Middle Name:
Last Name:CETNER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:535 E 70TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4823
Mailing Address - Country:US
Mailing Address - Phone:212-774-2024
Mailing Address - Fax:212-774-2025
Practice Address - Street 1:541 E 71ST ST FL 6
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4871
Practice Address - Country:US
Practice Address - Phone:212-774-2024
Practice Address - Fax:212-774-2025
Is Sole Proprietor?:No
Enumeration Date:2016-05-09
Last Update Date:2024-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY307612363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health