Provider Demographics
NPI:1366953218
Name:SYMANSKY, KRISTEN M (DO)
Entity type:Individual
Prefix:
First Name:KRISTEN
Middle Name:M
Last Name:SYMANSKY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 MAMMOTH RD STE 2
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03109-4135
Mailing Address - Country:US
Mailing Address - Phone:603-663-8300
Mailing Address - Fax:603-663-8149
Practice Address - Street 1:275 MAMMOTH RD STE 2
Practice Address - Street 2:
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03109-4135
Practice Address - Country:US
Practice Address - Phone:603-663-8300
Practice Address - Fax:603-663-8149
Is Sole Proprietor?:No
Enumeration Date:2017-10-18
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK147571208000000X
VA0102207206208000000X
390200000X
NH23962208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program