Provider Demographics
NPI:1316248230
Name:SISKIND, CARLY E (MS)
Entity type:Individual
Prefix:
First Name:CARLY
Middle Name:E
Last Name:SISKIND
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 PASTEUR DR STE A342
Mailing Address - Street 2:M/C 5235
Mailing Address - City:STANFORD
Mailing Address - State:CA
Mailing Address - Zip Code:94305-2200
Mailing Address - Country:US
Mailing Address - Phone:650-721-5588
Mailing Address - Fax:650-725-4197
Practice Address - Street 1:300 PASTEUR DR STE A342
Practice Address - Street 2:M/C 5235
Practice Address - City:STANFORD
Practice Address - State:CA
Practice Address - Zip Code:94305-2200
Practice Address - Country:US
Practice Address - Phone:650-721-5588
Practice Address - Fax:650-725-4197
Is Sole Proprietor?:No
Enumeration Date:2010-11-09
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS