Provider Demographics
NPI:1124743174
Name:SANFILIPPO, KRISTIN (MA SPECIAL EDUCATION)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:
Last Name:SANFILIPPO
Suffix:
Gender:F
Credentials:MA SPECIAL EDUCATION
Other - Prefix:
Other - First Name:KRISTIN
Other - Middle Name:
Other - Last Name:PALOPOLI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MA SPECIAL EDUCATION
Mailing Address - Street 1:3191 CHERRYWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WANTAGH
Mailing Address - State:NY
Mailing Address - Zip Code:11793-1825
Mailing Address - Country:US
Mailing Address - Phone:516-589-1589
Mailing Address - Fax:
Practice Address - Street 1:3191 CHERRYWOOD DR
Practice Address - Street 2:
Practice Address - City:WANTAGH
Practice Address - State:NY
Practice Address - Zip Code:11793-1825
Practice Address - Country:US
Practice Address - Phone:516-589-1589
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-11
Last Update Date:2022-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty