Provider Demographics
NPI:1285096438
Name:ERNST, KRISTINA (MD)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:
Last Name:ERNST
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 CLARKSON AVENUE, BOX 1262
Mailing Address - Street 2:DEPARTMENT SUNY DOWNSTATE MEDICAL CENTER
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203
Mailing Address - Country:US
Mailing Address - Phone:718-270-8867
Mailing Address - Fax:
Practice Address - Street 1:450 CLARKSON AVENUE, BOX 1262
Practice Address - Street 2:DEPARTMENT SUNY DOWNSTATE MEDICAL CENTER
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203
Practice Address - Country:US
Practice Address - Phone:718-270-8867
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-27
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
NY300192208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalist
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program