Provider Demographics
NPI:1124887989
Name:ECHEVERRIA, KIMBERLY (MEDICAL ASSISTANT)
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:
Last Name:ECHEVERRIA
Suffix:
Gender:F
Credentials:MEDICAL ASSISTANT
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:150 MOTOR PKWY STE 401
Mailing Address - Street 2:
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-5108
Mailing Address - Country:US
Mailing Address - Phone:646-627-7676
Mailing Address - Fax:888-387-5583
Practice Address - Street 1:150 MOTOR PKWY STE 401
Practice Address - Street 2:
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-5108
Practice Address - Country:US
Practice Address - Phone:646-627-7676
Practice Address - Fax:888-387-5583
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-15
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy