Provider Demographics
NPI:1194246165
Name:PROFILES BY KRISTIN LTD
Entity type:Organization
Organization Name:PROFILES BY KRISTIN LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:KRISTIN
Authorized Official - Middle Name:MICHELLE
Authorized Official - Last Name:WEBB
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-454-3132
Mailing Address - Street 1:2113 BREWERTON RD
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13211-1759
Mailing Address - Country:US
Mailing Address - Phone:315-454-3132
Mailing Address - Fax:315-454-9045
Practice Address - Street 1:2113 BREWERTON RD
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13211-1759
Practice Address - Country:US
Practice Address - Phone:315-454-3132
Practice Address - Fax:315-454-9045
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-06-29
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332BC3200XSuppliersDurable Medical Equipment & Medical SuppliesCustomized Equipment